Risk factors for incident chronic kidney disease following unilateral nephrectomy: a systematic review and meta-analysis
- 1Department of Urology, The Affiliated Hospital of Qingdao University
Abstract
Nephrectomy is standard for kidney tumors and living kidney donation, but postoperative chronic kidney disease (CKD) is a critical determinant of long-term outcomes. Risk factors for incident CKD after unilateral nephrectomy remain incompletely synthesized. PubMed, Embase, Web of Science, and Google Scholar were systematically searched from inception to January 2026. Eligible studies were adult cohort studies of patients with preserved preoperative kidney function (estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73 m2) undergoing unilateral nephrectomy. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models, as appropriate. Subgroup, leave-one-out sensitivity, and publication-bias analyses were performed. A total of 26 studies comprising 13,321 patients were included. Advanced age, male sex, diabetes mellitus, lower preoperative eGFR, higher preoperative serum creatinine, and radical nephrectomy were all significantly associated with an increased risk of postoperative CKD. In contrast, higher baseline eGFR was associated with a reduced risk. Each one-year increase in age was associated with a higher likelihood of CKD (adjusted OR = 1.05, 95% CI: 1.03–1.08). Compared with partial nephrectomy, radical nephrectomy significantly increased the risk of CKD (adjusted OR = 3.73, 95% CI: 2.27–6.13). Sensitivity analyses confirmed the robustness of the findings, although publication bias was detected for certain variables. Advanced age, diabetes, lower preoperative kidney function, and radical nephrectomy were associated with a higher risk of CKD after unilateral nephrectomy. Preoperative risk assessment, nephron-sparing surgery when oncologically appropriate, and risk-adapted follow-up may help reduce the postoperative CKD burden.
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BibTeX
@article{yan2026risk,
title = {{Risk factors for incident chronic kidney disease following unilateral nephrectomy: a systematic review and meta-analysis}},
author = {Yongchao Yan and Jingxian Wang and Wei Jiao and Xinning Wang},
journal = {Scientific Reports},
year = {2026},
month = aug,
doi = {10.1038/s41598-026-64417-8},
url = {https://doi.org/10.1038/s41598-026-64417-8},
note = {CC BY},
}
RIS
TY - JOUR
TI - Risk factors for incident chronic kidney disease following unilateral nephrectomy: a systematic review and meta-analysis
AU - Yongchao Yan
AU - Jingxian Wang
AU - Wei Jiao
AU - Xinning Wang
PY - 2026
DA - 2026/08/01
JO - Scientific Reports
DO - 10.1038/s41598-026-64417-8
UR - https://doi.org/10.1038/s41598-026-64417-8
AB - Nephrectomy is standard for kidney tumors and living kidney donation, but postoperative chronic kidney disease (CKD) is a critical determinant of long-term outcomes. Risk factors for incident CKD after unilateral nephrectomy remain incompletely synthesized. PubMed, Embase, Web of Science, and Google Scholar were systematically searched from inception to January 2026. Eligible studies were adult cohort studies of patients with preserved preoperative kidney function (estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73 m2) undergoing unilateral nephrectomy. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models, as appropriate. Subgroup, leave-one-out sensitivity, and publication-bias analyses were performed. A total of 26 studies comprising 13,321 patients were included. Advanced age, male sex, diabetes mellitus, lower preoperative eGFR, higher preoperative serum creatinine, and radical nephrectomy were all significantly associated with an increased risk of postoperative CKD. In contrast, higher baseline eGFR was associated with a reduced risk. Each one-year increase in age was associated with a higher likelihood of CKD (adjusted OR = 1.05, 95% CI: 1.03–1.08). Compared with partial nephrectomy, radical nephrectomy significantly increased the risk of CKD (adjusted OR = 3.73, 95% CI: 2.27–6.13). Sensitivity analyses confirmed the robustness of the findings, although publication bias was detected for certain variables. Advanced age, diabetes, lower preoperative kidney function, and radical nephrectomy were associated with a higher risk of CKD after unilateral nephrectomy. Preoperative risk assessment, nephron-sparing surgery when oncologically appropriate, and risk-adapted follow-up may help reduce the postoperative CKD burden.
SN - 2045-2322
ER -