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What is a Kidney Worth?

  • Eric J. Moskowitz
Chapter

Abstract

Upper urinary tract urothelial carcinoma (UTUC) has traditionally been managed with radical extirpative surgery. However, conservative management with kidney-sparing endoscopic surgery is currently performed not only in those patients with imperative indications but also in those patients with low risk disease and normal, functioning contralateral kidneys, due to its similar oncological efficacy. Recent analyses relevant to our current era of cost-effective management have enabled us to understand the variety of costs associated with preserving a kidney with UTUC. Kidney-sparing surgery for UTUC offers value in delaying progression to chronic kidney disease (CKD), end-stage renal disease (ESRD), and their associated cardiovascular morbidity and mortality. By delaying the progression to CKD and ESRD, conservative endoscopic management of UTUC also effectively reduces ESRD expenditures. The kidney’s worth is ultimately furthered by the elimination of the negative impact of CKD and ESRD on a patient’s quality of life.

Keywords

Upper urinary tract urothelial carcinoma Kidney-sparing surgery Financial costs End-stage renal disease Chronic kidney disease Quality of life 

References

  1. 1.
    Rai BP, Shelley M, Coles B, Somani B, Nabi G. Surgical management for upper urinary tract transitional cell carcinoma (UUT-TCC): a systematic review. BJU Int. 2012;110(10):1426–35.CrossRefPubMedGoogle Scholar
  2. 2.
    Seisen T, Colin P, Roupret M. Risk-adapted strategy for the kidney-sparing management of upper tract tumours. Nat Rev Urol. 2015;12(3):155–66.CrossRefPubMedGoogle Scholar
  3. 3.
    Pak RW, Moskowitz EJ, Bagley DH. What is the cost of maintaining a kidney in upper-tract transitional-cell carcinoma? An objective analysis of cost and survival. J Endourol. 2009;23(3):341–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Russo P. Partial nephrectomy achieves local tumor control and prevents chronic kidney disease. Expert Rev Anticancer Ther. 2006;6(12):1745–51.CrossRefPubMedGoogle Scholar
  5. 5.
    Lau WK, Blute ML, Weaver AL, Torres VE, Zincke H. Matched comparison of radical nephrectomy vs nephron-sparing surgery in patients with unilateral renal cell carcinoma and a normal contralateral kidney. Mayo Clin Proc. 2000;75(12):1236–42.CrossRefPubMedGoogle Scholar
  6. 6.
    McKiernan J, Simmons R, Katz J, Russo P. Natural history of chronic renal insufficiency after partial and radical nephrectomy. Urology. 2002;59(6):816–20.CrossRefPubMedGoogle Scholar
  7. 7.
    Huang WC, Levey AS, Serio AM, Snyder M, Vickers AJ, Raj GV, et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol. 2006;7(9):735–40.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Li L, Lau WL, Rhee CM, Harley K, Kovesdy CP, Sim JJ, et al. Risk of chronic kidney disease after cancer nephrectomy. Nat Rev Nephrol. 2014;10(3):135–45.CrossRefPubMedGoogle Scholar
  9. 9.
    Van Poppel H, Da Pozzo L, Albrecht W, Matveev V, Bono A, Borkowski A, et al. A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol. 2011;59(4):543–52.CrossRefPubMedGoogle Scholar
  10. 10.
    Kaushik D, Kim SP, Childs MA, Lohse CM, Costello BA, Cheville JC, et al. Overall survival and development of stage IV chronic kidney disease in patients undergoing partial and radical nephrectomy for benign renal tumors. Eur Urol. 2013;64(4):600–6.CrossRefPubMedGoogle Scholar
  11. 11.
    Trivedi H. Cost implications of caring for chronic kidney disease: are interventions cost-effective? Adv Chronic Kidney Dis. 2010;17(3):265–70.CrossRefPubMedGoogle Scholar
  12. 12.
    Kent S, Schlackow I, Lozano-Kuhne J, Reith C, Emberson J, Haynes R, et al. What is the impact of chronic kidney disease stage and cardiovascular disease on the annual cost of hospital care in moderate-to-severe kidney disease? BMC Nephrol. 2015;16:65.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Wyld ML, Lee CM, Zhuo X, White S, Shaw JE, Morton RL, et al. Cost to government and society of chronic kidney disease stage 1–5: a national cohort study. Intern Med J. 2015;45(7):741–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Miyakawa M, Yoshida O. [The quality of life in patients with bladder cancer after radical cystectomy with ileal conduit: II. Results of questionnaire surveys to compare the impact of treatments]. Nihon Gan Chiryo Gakkai shi. 1987;22(7):1296–303.Google Scholar
  15. 15.
    Mack D, Frick J. Quality of life in patients undergoing bacille calmette-guerin therapy for superficial bladder cancer. Br J Urol. 1996;78(3):369–71.CrossRefPubMedGoogle Scholar
  16. 16.
    Hart S, Skinner EC, Meyerowitz BE, Boyd S, Lieskovsky G, Skinner DG. Quality of life after radical cystectomy for bladder cancer in patients with an ileal conduit, cutaneous or urethral kock pouch. J Urol. 1999;162(1):77–81.CrossRefPubMedGoogle Scholar
  17. 17.
    Kitamura H, Miyao N, Yanase M, Masumori N, Matsukawa M, Takahashi A, et al. Quality of life in patients having an ileal conduit, continent reservoir or orthotopic neobladder after cystectomy for bladder carcinoma. Int J Urol. 1999;6(8):393–9.CrossRefPubMedGoogle Scholar
  18. 18.
    Fujisawa M, Isotani S, Gotoh A, Okada H, Arakawa S, Kamidono S. Health-related quality of life with orthotopic neobladder versus ileal conduit according to the SF-36 survey. Urology. 2000;55(6):862–5.CrossRefPubMedGoogle Scholar
  19. 19.
    Hardt J, Filipas D, Hohenfellner R, Egle UT. Quality of life in patients with bladder carcinoma after cystectomy: first results of a prospective study. Qual Life Res Int J Qual Life Aspects Treat Care Rehabil. 2000;9(1):1–12.CrossRefGoogle Scholar
  20. 20.
    McGuire MS, Grimaldi G, Grotas J, Russo P. The type of urinary diversion after radical cystectomy significantly impacts on the patient’s quality of life. Ann Surg Oncol. 2000;7(1):4–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Dutta SC, Chang SC, Coffey CS, Smith JA Jr, Jack G, Cookson MS. Health related quality of life assessment after radical cystectomy: comparison of ileal conduit with continent orthotopic neobladder. J Urol. 2002;168(1):164–7.CrossRefPubMedGoogle Scholar
  22. 22.
    Hara I, Miyake H, Hara S, Gotoh A, Nakamura I, Okada H, et al. Health-related quality of life after radical cystectomy for bladder cancer: a comparison of ileal conduit and orthotopic bladder replacement. BJU Int. 2002;89(1):10–3.CrossRefPubMedGoogle Scholar
  23. 23.
    Mansson A, Davidsson T, Hunt S, Mansson W. The quality of life in men after radical cystectomy with a continent cutaneous diversion or orthotopic bladder substitution: is there a difference? BJU Int. 2002;90(4):386–90.CrossRefPubMedGoogle Scholar
  24. 24.
    Matsuda T, Aptel I, Exbrayat C, Grosclaude P. Determinants of quality of life of bladder cancer survivors five years after treatment in France. Int J Urol Official J Japanese Urol Assoc. 2003;10(8):423–9.Google Scholar
  25. 25.
    Yoneda T, Igawa M, Shiina H, Shigeno K, Urakami S. Postoperative morbidity, functional results and quality of life of patients following orthotopic neobladder reconstruction. Int J Urol. 2003;10(3):119–25.CrossRefPubMedGoogle Scholar
  26. 26.
    Yoshimura K, Utsunomiya N, Ichioka K, Matsui Y, Terai A, Arai Y. Impact of superficial bladder cancer and transurethral resection on general health-related quality of life: an SF-36 survey. Urology. 2005;65(2):290–4.CrossRefPubMedGoogle Scholar
  27. 27.
    Churchill DN, Torrance GW, Taylor DW, Barnes CC, Ludwin D, Shimizu A, et al. Measurement of quality of life in end-stage renal disease: the time trade-off approach. Clin Invest Med. 1987;10(1):14–20.PubMedGoogle Scholar
  28. 28.
    Klinghoffer Z, Tarride JE, Novara G, Ficarra V, Kapoor A, Shayegan B, et al. Cost-utility analysis of radical nephrectomy versus partial nephrectomy in the management of small renal masses: adjusting for the burden of ensuing chronic kidney disease. Can Urol Assoc J (Journal de l’Association des urologues du Canada). 2013;7(3–4):108–13.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Stamford Health Medical GroupStamfordUSA

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