Department of Radiology, Division of Interventional Radiology, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104, USA.
J Vasc Interv Radiol. 2012 Jan;23(1):41-5. doi: 10.1016/j.jvir.2011.09.002. Epub 2011 Oct 22.
To examine the effect of percutaneous thermal ablation of renal masses on renal function among patients with baseline chronic kidney disease (CKD).
Patients with baseline CKD (initial glomerular filtration rate [GFR] < 60 mL/min/1.73 m(2)) who underwent percutaneous cryoablation or radiofrequency (RF) ablation of renal masses were reviewed.
A total of 48 patients with a GRF of 60 mL/min/1.73 m(2) or lower were treated with renal cryoablation or RF ablation and had follow-up GFR measurement 1 month afterward. Mean patient age was 73 years (range, 47-89 y). Cryoablation was performed in 22 patients and RF ablation was performed in 26. Mean tumor diameter was 3.4 cm (range, 0.9-10.2 cm). Mean overall GFRs were 39.8 mL/min/1.73 m(2) at baseline and 39.7 mL/min/1.73 m(2) at 1 month after ablation (P = .85). A total of 38 patients had 1-year follow-up GFR measurement (cryoablation, n = 18; RF ablation, n = 20), and their mean GFR was 40.9 mL/min/1.73 m(2) ± 11.4 (SD), compared with a preablation GFR of 41.2 mL/min/1.73 m(2)(P = .79). In the cryoablation group, mean GFRs at 1 month and 1 year were 41.4 mL/min/1.73 m(2) and 44.4 mL/min/1.73 m(2), compared with respective baseline GFRs of 41.1 mL/min/1.73 m(2) and 42.1 mL/min/1.73 m(2) (P = .75 and P = .19, respectively). In the RF ablation group, mean GFRs at 1 month and 1 year were 38.2 mL/min/1.73 m(2) and 37.8 mL/min/1.73 m(2), compared with respective baseline GFRs of 38.7 mL/min/1.73 m(2) and 40.4 mL/min/1.73 m(2) (P = .58 and P = .09, respectively).
Independent of ablation modality, percutaneous renal mass ablation does not appear to affect renal function among patients with CKD.
探讨经皮热消融治疗基线慢性肾脏病（CKD）患者肾肿块对肾功能的影响。
对接受经皮冷冻消融或射频（RF）消融治疗肾肿块且基线 CKD（初始肾小球滤过率[GFR]＜60 mL/min/1.73 m(2)）的患者进行了回顾性分析。
48 例 GFR 为 60 mL/min/1.73 m(2)或更低的患者接受了肾冷冻消融或 RF 消融治疗，并在 1 个月后进行了后续 GFR 测量。患者平均年龄为 73 岁（范围，47-89 岁）。22 例患者行冷冻消融，26 例行 RF 消融。平均肿瘤直径为 3.4 cm（范围，0.9-10.2 cm）。基线时平均总体 GFR 为 39.8 mL/min/1.73 m(2)，消融后 1 个月为 39.7 mL/min/1.73 m(2)（P=.85）。38 例患者有 1 年的随访 GFR 测量（冷冻消融，n=18；RF 消融，n=20），其平均 GFR 为 40.9 mL/min/1.73 m(2)±11.4（标准差），与消融前的 GFR 41.2 mL/min/1.73 m(2)相比（P=.79）。冷冻消融组中，1 个月和 1 年的平均 GFR 分别为 41.4 mL/min/1.73 m(2)和 44.4 mL/min/1.73 m(2)，与各自的基线 GFR 41.1 mL/min/1.73 m(2)和 42.1 mL/min/1.73 m(2)相比（P=.75 和 P=.19）。在 RF 消融组中，1 个月和 1 年的平均 GFR 分别为 38.2 mL/min/1.73 m(2)和 37.8 mL/min/1.73 m(2)，与各自的基线 GFR 38.7 mL/min/1.73 m(2)和 40.4 mL/min/1.73 m(2)相比（P=.58 和 P=.09）。
无论消融方式如何，经皮肾肿块消融术似乎不会影响 CKD 患者的肾功能。
