{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:52:30Z","timestamp":1790949150375,"version":"4.1.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T00:00:00Z","timestamp":1707955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T00:00:00Z","timestamp":1707955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Radiat Oncol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Stereotactic ablative body radiotherapy (SABR) is an emerging treatment for patients with primary renal cell carcinoma (RCC). However, its impact on renal function is unclear. This study aimed to evaluate incidence and clinical factors predictive of severe to end-stage chronic kidney disease (CKD) after SABR for RCC.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods and materials<\/jats:title>\n                <jats:p>This was a Single institutional retrospective analysis of patients with diagnosed primary RCC receiving SABR between 2012\u20132020. Adult patients with no metastatic disease, baseline estimated glomerular filtration rate (eGFR) of\u2009\u2265\u200930\u00a0ml\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup>, and at least one post-SABR eGFR at six months or later were included in this analysis. Patients with upper tract urothelial carcinoma were excluded. Primary outcome was freedom from severe to end-stage CKD, determined using the Kaplan\u2013Meier estimator. The impact of baseline CKD, age, hypertension, diabetes, tumor size and fractionation schedule were assessed by Cox proportional hazard models.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Seventy-eight consecutive patients were included, with median age of 77.8\u00a0years (IQR 70\u201383), tumor size of 4.5\u00a0cm (IQR 3.9\u20135.8) and follow-up of 42.2\u00a0months (IQR 23\u201360). Baseline median eGFR was 58 mls\/min; 55% (n\u2009=\u200943) of patients had baseline CKD stage 3 and the remainder stage 1\u20132. By last follow-up, 1\/35 (2.8%) of baseline CKD 1\u20132, 7\/27 (25.9%) CKD 3a and 11\/16 (68.8%) CKD 3b had developed CKD stage 4\u20135. The estimated probability of freedom from CKD stage 4\u20135 at 1 and 5\u00a0years was 89.6% (CI 83.0\u201397.6) and 65% (CI 51.4\u201381.7) respectively. On univariable analysis, worse baseline CKD (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and multi-fraction SABR (<jats:italic>p<\/jats:italic>\u2009=\u20090.005) were predictive for development of stage 4\u20135 CKD though only the former remained significant in multivariable model.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In this elderly cohort with pre-existing renal dysfunction, SABR achieved satisfactory nephron sparing with acceptable rates of severe to end-stage CKD. It can be an attractive option in patients who are medically inoperable.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13014-024-02413-w","type":"journal-article","created":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T02:02:09Z","timestamp":1707962529000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Low rate of severe-end-stage kidney disease after SABR for localised primary kidney cancer"],"prefix":"10.1186","volume":"19","author":[{"given":"Muhammad","family":"Ali","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendrick","family":"Koo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng F.","family":"Oon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Moon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Declan G.","family":"Murphy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renu","family":"Eapen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Goad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Lawrentschuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun A.","family":"Azad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarat","family":"Chander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Shaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Hardcastle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shankar","family":"Siva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,15]]},"reference":[{"issue":"6","key":"2413_CR1","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1016\/j.eururo.2022.06.017","volume":"82","author":"M Ali","year":"2022","unstructured":"Ali M, Mooi J, Lawrentschuk N, McKay RR, Hannan R, Lo SS, et al. 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NH: Research grant funding for kidney SABR from Varian Medical Systems, and research grant funding from Reflexion Medical for biological guided radiation therapy. A consultant with SeeTreat Medical. AAA: Consultant\u2014Astellas, Janssen, Novartis, Aculeus Therapeutics, Speakers Bureau\u2014Astellas, Janssen, Novartis, Amgen, Ipsen, Bristol Myers Squibb; Merck Serono, Bayer. Honoraria\u2014Astellas, Novartis, Sanofi, AstraZeneca, Tolmar, Telix; Merck Serono; Janssen, Bristol Myers Squibb, Ipsen, Bayer, Pfizer, Amgen, Noxopharm, Merck Sharpe Dome, Aculeus Therapeutics, Daiichi Sankyo. Scientific Advisory Board\u2014Astellas, Novartis, Sanofi, AstraZeneca, Tolmar, Pfizer, Telix; Merck Serono; Janssen, Bristol Myers Squibb, Ipsen, Bayer, Merck Sharpe Dome, Amgen, Noxopharm,Daiichi Sankyo, Arvinas. Travel\u2009+\u2009Accommodation\u2014Astellas, Merck Serono, Amgen, Novartis, Janssen, Tolmar, Pfizer; Bayer. Research Funding\u2014Astellas (investigator), Merck Serono (investigator), Astra Zeneca (investigator), Bristol Myers Squibb (institutional), Astra Zeneca (institutional), Aptevo Therapeutics (institutional), Glaxo Smith Kline (institutional), Pfizer (institutional), MedImmune (institutional), Astellas (institutional), SYNthorx (institutional), Bionomics (institutional), Sanofi Aventis (institutional), Novartis (institutional), Ipsen (institutional), Exelixis (institutional), Merck Sharpe Dome (institutional), Janssen (institutional), Eli Lilly (institutional), Gilead Sciences (institutional), Merck Serono (institutional), Hinova (institutional), Steering Committee\u2014Astellas, Exelixis, Pfizer.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"23"}}