Of particular concern, the researchers noted, is that patients with pre-existing chronic kidney disease (CKD) had a nearly twofold increased likelihood of undergoing RN than NSM compared with patients without CKD. Even though NSM use increased over the study period, most CKD patients still received RN, the investigators found.
This study looked at data from the 1998-2008 and found that most renal masses were being treated by removing the entire kidney, even in patients with kidney disease. I have been performing partial nephrectomies for renal masses that were less than 4cm since I was at Indiana in 1997. Over the last 5 years, I have performing partial nephrectomies for tumors as large as 9cm if the location would allow it.