Renal Function After CT-Guided Cryoablation of Small Renal Tumours in Patients with Solitary Kidney

Percutaneous CT-guided cryoablation has emerged over the past decade as a nephron-sparing alternative to partial nephrectomy for small renal cell carcinomas (RCC), particularly in patients with solitary kidneys who are at heightened risk for postoperative renal insufficiency. While current guidelines continue to favor surgical management for T1 lesions, international bodies such as the American Urological Association and European Society for Medical Oncology acknowledge ablative techniques for patients with comorbidities or limited renal reserve. Given the lack of large multicenter data on functional outcomes in this high-risk cohort, the present European Registry for Renal Cryoablation (EuRECA) study was designed to prospectively assess changes in estimated glomerular filtration rate (eGFR) following a single percutaneous cryoablation session in patients with solitary kidneys harboring biopsy-proven RCC.

In a subset of 70 patients drawn from an initial 222 individuals registered between 2014 and 2020, mean baseline eGFR was 55.8 ± 16.8 mL/min/1.73 m² and declined to 49.6 ± 16.5 mL/min/1.73 m² at three months post-ablation, representing an average reduction of 6.2 mL/min/1.73 m² (11.1 %; p < 0.001). Importantly, no patient progressed to end-stage chronic kidney disease (stage IV or V), nor required acute dialysis, despite a statistically significant drop in renal function. These findings support the safety and efficacy of CT-guided cryoablation in preserving renal function in solitary-kidney patients with small RCCs, offering a viable minimally invasive treatment option in multidisciplinary care.