Cancer - Kidney(구연) (E-075) 수술 후 발생한 만성신부전과 내과적 만성신부전의 사망과 말기신부전 진행에 대한 비교분석: 코호트 연구 ¹서울대학교 의과대학 비뇨의학교실 ²서울대학교 의과대학 내과학교실 신장분과 김민혁¹, 정규환¹, 유상현¹, 윤현식¹, 박대형¹, 서준교¹, 육형동¹, 구자현¹, 곽철¹, 김현회¹, 강민정², 오국환², 정창욱¹ Purpose: We aim to compare survival and progression to end-stage renal disease in patients who underwent partial nephrectomy or radical nephrectomy due to early stage renal cell carcinoma and patients with medical chronic kidney disease (CKD) patients. Materials and Methods: We compared surgery-induced CKD (CKD-S) patients with medical CKD (CKD-M) patients. We selected CKD-S patients from the Seoul National University-renal cell carcinoma (SNUG-RCC) database who underwent partial or radical nephrectomy from January 2002 to March 2019 to treat early stage RCC (T1N0M0). We used the prospective KoreaN cohort study for Outcome in patients with CKD (KNOW-CKD) as CKD-M group. CKD-M patients were recruited from 2011 to 2015 of KNOW-CKD cohort. CKD-S patients were stratified according to CKD grade using MDRD GFR around 3 months after surgery. End-stage renal disease (ESRD) was defined as initiation of dialysis or kidney transplantation. Results: In the CKD-S group, 365 out of 1,702 (21.4%) were grade 3 or higher, whereas 1,512 out of 2,180 (69.4%) were in the CKD-M group. Mean age was 61.7 in CKD-S, and 56.3 in CKD-M (p<0.001). BMI was higher in CKD-S group (25.2 vs. 24.6, p=0.005). Proportion of hypertension (56.0% vs. 98.3%, p<0.001) and diabetes (21.6% vs. 40.3%, p<0.001) were higher in CKD-M group. Initial estimated glomerular filtration rate (eGFR) was similar between CKD-S and CKD-M (48.0 vs 48.7, p=0.392). In the CKD-S group, initial grade 3 was more dominant than CKD-M group (95.3% vs 57.5%, p<0.001). Among patients with CKD grade 3 or higher, CKD-S was associated with longer overall survival (7-yr overall survival rate 94.2% vs. 90.0%, p=0.011) and longer duration to ESRD (7-yr ESRD-free rate 98.4% vs. 49.1%, p<0.001). Conclusions: Risk of progression to ESRD or mortality in patients with CKD-S may be lower than those of patients with CKD-M. CKD grade system is not valid in patients with CKD-S, thus they should not be managed as CKD-M patients with equivalent CKD grade. keywords : Chronic kidney disease, Nephrectomy, End stage renal disease