Abstract
Purpose
Neoplastic, infectious and calculous diseases, as well as congenital anomaly and vascular disorder of the kidney, are known to be the main indications of a nephrectomy. However, the incidences of a nephrectomy in various renal diseases differ with respect to several factors, such as the socioeconomic situation, and differences in time and regions. This study was performed to investigate the changes of the causes of a nephrectomy and the associated factors between 1980 and 2005.
Materials and Methods
All 116,535 in-patients admitted to the Urological Department of Kangnam Sacred Heart Hospital from 1980 to 2005 were enrolled in this study, and divided into 3 groups, Period I from January 1980 to December 1987, Period II from January 1990 to December 1997, and Period III from January 2000 to December 2005. Of these patients, 11,565 (9.9%) underwent urological operations, and 234 (2.0%) were treated with a nephrectomy for various renal diseases.
Results
The causes for the nephrectomy in Period I were renal stones (30%), infection-inflammatory diseases (28.75%), congenital anomalies (15%), renal tumors (13.75%), renal injuries (10%), but tumors (41.7%), renal stones (21.4%), congenital anomalies (19.05%), infection-inflammatory diseases (8.3%) and renal injuries (5.6%) in Period II, and tumors (57.1%), congenital anomalies (17.1%), renal stones (14.3%), infection-inflammatory diseases (8.57%) and renal injuries (1.4%) in Period III, in that order (p<0.001).
Conclusions
The incidence of renal tumors has increased, but those of infection-inflammatory diseases and renal injuries have decreased. Among the renal diseases requiring a nephrectomy, renal tumors were ranked in first position, but the nephrectomy rate for benign renal diseases has markedly decreased over time, which is similar to that of developed countries.
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Table 1.
Table 2.
Table 3.
Period I | Period II | Period III | p-value | |
---|---|---|---|---|
No. of patient | 80 | 84 | 70 | |
Mean age | 39.06±14.71 | 48.79±17.76 | 53.44±17.05 | <0.001∗ |
(years) | ||||
Male/Female | 42/38 | 44/40 | 39/31 | 0.906† |
(1.11:1) | (1.1:1) | (1.26:1) | ||
Right/Left | 41/39 | 51/33 | 28/42 | 0.513† |
Table 4.
Disease | No. of patients (%) | p-value∗ | ||
---|---|---|---|---|
Period I | Period II | Period III | ||
Tumor | 11 (13.75) | 35 (41.7) | 40 (57.1) | <0.001 |
Inflammation | 23 (28.75) | 7 (8.3) | 6 (8.57) | <0.001 |
Tuberculosis† | 18 (22.5) | 4 (4.94) | 3 (4.3) | |
Renal stone | 24 (30.0) | 18 (21.4) | 10 (14.3) | <0.001 |
Injury | 8 (10.0) | 5 (5.95) | 1 (1.43) | <0.001 |
Congenital | 12 (15.0) | 16 (19.05) | 12 (17.1) | <0.001 |
anomaly | ||||
Others | 2 (2.5) | 3 (3.6) | 1 (1.4) | <0.001 |
Total | 80 (100) | 84 (100) | 70 (100) |
Table 5.
Disease | No. of nephrectomy/No. of total patients (%) | ||||||
---|---|---|---|---|---|---|---|
Period | Tumor | Inflammation∗ | [Tuberculosis]† | Renal stone∗ | Injury† | Congenital anomaly | Total∗ |
Period I | 11/25 (44.0) | 23/106 (21.7) | 18/46 (39.1) | 24/127 (18.9) | 8/47 (17.0) | 12/38 (31.6) | 80/343 (23.3) |
Period II | 35/86 (40.69) | 7/97 (7.2) | 4/49 (8.2) | 18/205 (8.78) | 5/69 (7.2) | 16/183 (8.7) | 84/640 (13.1) |
Period III | 40/108 (37.0) | 6/89 (6.7) | 3/62 (4.8) | 10/152 (6.58) | 1/29 (3.4) | 12/209 (5.7) | 70/587 (11.9) |
p-value | 0.441 | 0.009 | <0.0001 | <0.0001 | 0.049 | 0.442 | <0.0001 |