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Comparative long-term risks of chronic kidney disease and dialysis following conservative treatment, renal artery embolization, or nephrectomy in patients with blunt kidney injuries: retrospective cohort study.

Comparative long-term risks of chronic kidney disease and dialysis following conservative treatment, renal artery embolization, or nephrectomy in patients with blunt kidney injuries: retrospective cohort study.

期刊: BJS open 日期: 2026-05-12 PMID: 42224098 DOI: 10.1093/bjsopen/zrag051 浏览: 50
作者: Tang JM, Kuo LW, Huang JF, Hsu CP, Cheng CT, Chen HW, Wu CH, Wong YC, Chen SA, Wang CC
JM, T., LW, K., JF, H., CP, H., CT, C., HW, C., CH, W., YC, W., SA, C., & CC, W. (2026). Comparative long-term risks of chronic kidney disease and dialysis following conservative treatment, renal artery embolization, or nephrectomy in patients with blunt kidney injuries: retrospective cohort study.. BJS open. https://doi.org/10.1093/bjsopen/zrag051
JM T, LW K, JF H, CP H, CT C, HW C, et al. Comparative long-term risks of chronic kidney disease and dialysis following conservative treatment, renal artery embolization, or nephrectomy in patients with blunt kidney injuries: retrospective cohort study.. BJS open. 2026; doi: 10.1093/bjsopen/zrag051
JM T, LW K, JF H, et al. Comparative long-term risks of chronic kidney disease and dialysis following conservative treatment, renal artery embolization, or nephrectomy in patients with blunt kidney injuries: retrospective cohort study.[J]. BJS open. 2026. DOI: 10.1093/bjsopen/zrag051.
@article{jm2026,
  author = {Tang JM and Kuo LW and Huang JF and Hsu CP and Cheng CT and Chen HW and Wu CH and Wong YC and Chen SA and Wang CC},
  title = {Comparative long-term risks of chronic kidney disease and dialysis following conservative treatment, renal artery embolization, or nephrectomy in patients with blunt kidney injuries: retrospective cohort study.},
  journal = {BJS open},
  year = {2026},
  doi = {10.1093/bjsopen/zrag051},
  note = {PMID: 42224098},
}
TY  - JOUR
AU  - Tang JM
AU  - Kuo LW
AU  - Huang JF
AU  - Hsu CP
AU  - Cheng CT
AU  - Chen HW
AU  - Wu CH
AU  - Wong YC
AU  - Chen SA
AU  - Wang CC
TI  - Comparative long-term risks of chronic kidney disease and dialysis following conservative treatment, renal artery embolization, or nephrectomy in patients with blunt kidney injuries: retrospective cohort study.
T2  - BJS open
PY  - 2026
DO  - 10.1093/bjsopen/zrag051
AN  - PMID:42224098
ER  - 

摘要

BACKGROUND: Long-term changes in renal function following blunt kidney injury (BKI) remain insufficiently studied, particularly in patients who undergo renal artery embolization (RAE). The aim of this study was to clarify the long-term risks of chronic kidney disease (CKD) and dialysis in patients with BKI after unilateral nephrectomy, RAE, or conservative treatment. The hypothesis was that both unilateral nephrectomy and RAE would increase these risks compared with conservative treatment, with RAE posing a lower risk. METHODS: This retrospective cohort study used data from Taiwan's National Health Insurance Research Database from 2001 to 2019, focusing on patients with BKIs. Outcomes included long-term CKD risks, lifelong dialysis, and all-cause mortality. Inverse probability of treatment weighting was used to minimize confounding. RESULTS: During the study, 19 013 patients were diagnosed with BKIs; of these, 12 709 were analysed (unilateral nephrectomy, 274 (2.1%); RAE, 510 (4.0%); conservative treatment, 11 925 (93.8%)). The mean(standard deviation) age was 39.7(17.1) years, 69.4% were male, and the mean follow-up duration was 10.7(5.2) years. Compared with conservative treatment, patients undergoing unilateral nephrectomy (subdistribution hazard ratio (SHR) 1.97; 95% confidence interval (c.i.) 1.86 to 2.10) or RAE (SHR 1.17, 95% c.i. 1.09 to 1.26) had a higher risk of CKD. In addition, patients in the nephrectomy and RAE groups had an increased risk of lifelong dialysis, with an SHR of 3.97 (95% c.i. 3.09 to 5.10) and 1.46 (95% c.i. 1.07 to 1.99), respectively. Unilateral nephrectomy was associated with a higher risk of all-cause mortality than RAE and conservative treatment, with hazard ratios of 1.14 (95% c.i. 1.06 to 1.23) and 1.63 (95% c.i. 1.52 to 1.75), respectively. CONCLUSIONS: Patients with BKIs are at higher risk of long-term CKD and potential lifelong dialysis after both unilateral nephrectomy and RAE, with RAE presenting a lower risk than nephrectomy. Patients with BKIs who undergo unilateral nephrectomy or RAE require follow-up to monitor renal function and receive health education on kidney protection.

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