Comparative Analysis of Renal Functional Outcomes and Overall Survival of Elderly vs Nonelderly Patients Undergoing Radical Nephrectomy

To evaluate changes in renal function and overall survival in elderly vs nonelderly patients undergoing radical nephrectomy (RN) for renal masses. We reviewed available records of 392 patients undergoing RN from 2008 through 2013. Patients were divided into elderly, defined as ≥70 years old (n = 110), or nonelderly (n = 282) at the time of nephrectomy. The groups were compared for perioperative characteristics, renal functional outcomes, and overall survival. Standard Student's t-tests were used for continuous variables and Fischer's exact tests for categorical comparisons. Kaplan-Meier estimate models for survival were compared using log-rank tests. Elderly patients were more likely to have comorbidities. Preoperative estimated glomerular filtration rate (GFR) of elderly patients was significantly lower (65.6 vs 77.9 mL/minute/1.73 m , p = 0.0002), as was GFR at discharge (47.7 vs 57.2 mL/minute/1.73 m , p = 0.001) and at maximum follow-up (46.8 vs 57.4 mL/minute/1.73 m , p = 0.001). Of the patients with GFR >60 before surgery, de novo CKD stage III progression (defined as GFR