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Purpose <p>Endoscopic management offers renal-sparing approaches for upper tract urothelial carcinoma (UTUC). We sought to characterize the impact of endoscopically managing UTUC on kidney function and identify predictors of renal function decline.</p> Methods <p>We queried a multi-institutional cohort of endoscopically managed UTUC. Estimated glomerular filtration rate values 12 months after endoscopic treatment were assigned according to the National Kidney Function Kidney Disease Outcomes Quality Initiative (KDOQI) chronic kidney disease (CKD) stages. Loss of kidney function was defined as an increase by at least one CKD stage. Severe loss was defined as an increase by at least 2 CKD stages or development of CKD stage 3b–5.</p> Results <p>A total of 339 patients (521 interventions) were included. 113 patients (33.3%) experienced loss of kidney function and 75 (22.1%) experienced severe loss of kidney function. In multivariable logistic regression, high grade tumor (OR 2.29, 95% CI 1.23–4.33) and renal pelvic location (OR: 2.64, 95% CI 1.32–5.54) were significantly associated with loss of kidney function on a per-patient level. We observed similar results on a per-intervention analysis, with higher odds for kidney function loss for high grade tumor (OR 2.03, 95% CI 1.23–3.35) and renal pelvic location (OR 1.76, 95% CI 1.01–3.08).</p> Conclusion <p>Despite preservation of the renal unit, one-third of patients undergoing endoscopic management of UTUC experience loss of kidney function. High-grade tumors and renal pelvic location were associated with adverse renal function outcomes.</p>

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Renal function outcomes following endoscopic management of upper tract urothelial carcinoma

  • 期刊论文

  • 发表日期：

    2026年5月22日

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  • Philipp Korn,
  • Mark Essien,
  • Maximilian Pallauf,
  • Joseph Cheaib,
  • Soum Lokeshwar,
  • Jaime O. Herrera-Caceres,
  • Alexander Small,
  • Dima Raskolnikov,
  • Nir Kleinmann,
  • Asaf Shvero,
  • Surena F. Matin,
  • Craig Labbate,
  • Hristos Kaimakliotis,
  • Isamu Tachibana,
  • Jennifer Linehan,
  • Jane Choe,
  • Ojas Shah,
  • Miyad Movassaghi,
  • William Huang,
  • Jesse Persily,
  • Aaron Perecman,
  • David Canes,
  • Rodrigo R. Pessoa,
  • Aaron Potretzke,
  • Jay D. Raman,
  • Nirmish Singla

摘要

Purpose

Endoscopic management offers renal-sparing approaches for upper tract urothelial carcinoma (UTUC). We sought to characterize the impact of endoscopically managing UTUC on kidney function and identify predictors of renal function decline.

Methods

We queried a multi-institutional cohort of endoscopically managed UTUC. Estimated glomerular filtration rate values 12 months after endoscopic treatment were assigned according to the National Kidney Function Kidney Disease Outcomes Quality Initiative (KDOQI) chronic kidney disease (CKD) stages. Loss of kidney function was defined as an increase by at least one CKD stage. Severe loss was defined as an increase by at least 2 CKD stages or development of CKD stage 3b–5.

Results

A total of 339 patients (521 interventions) were included. 113 patients (33.3%) experienced loss of kidney function and 75 (22.1%) experienced severe loss of kidney function. In multivariable logistic regression, high grade tumor (OR 2.29, 95% CI 1.23–4.33) and renal pelvic location (OR: 2.64, 95% CI 1.32–5.54) were significantly associated with loss of kidney function on a per-patient level. We observed similar results on a per-intervention analysis, with higher odds for kidney function loss for high grade tumor (OR 2.03, 95% CI 1.23–3.35) and renal pelvic location (OR 1.76, 95% CI 1.01–3.08).

Conclusion

Despite preservation of the renal unit, one-third of patients undergoing endoscopic management of UTUC experience loss of kidney function. High-grade tumors and renal pelvic location were associated with adverse renal function outcomes.