Simple Nephrectomy in a Tertiary Care Safety Net Hospital—Patient Characteristics, Causes, Cost, and Renal Function Implications

Kyle S. Ames, Fady Baky, Somer Blair, Jorge Sanchez, Whitney Franklin, Andrew Barefoot, Jessica Mears, Patricia Magness, Brett Johnson, Tolulope Bakare, Steve Hudak, Jodi Antonelli, Ryan Hutchinson, Yair Lotan, Solomon L. Woldu

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate factors associated with simple nephrectomy at a safety net hospital with a diverse patient population and large catchment area. Simple nephrectomy is an underreported surgery. Performance of simple nephrectomy may represent a failure of management of underlying causes. Methods: We performed a retrospective review of simple nephrectomies performed at a major urban safety net hospital from 2014 to 2019. Detailed demographic, surgical, and renal functional outcomes were abstracted. We assessed the medical and social factors leading to performance of simple nephrectomy and report contemporaneous perception of preventability of the simple nephrectomy by the surgeon. Results: Eighty-five patients underwent simple nephrectomy during the study period; 55% were non-white, 77% were women, and the median age at time of surgery was 46 years. The most common medical factors contributing to simple nephrectomy were stone disease in 55.3%, followed by retained ureteral stent (30.6%) and stricture (30.6%). The most common social factors were lack of insurance (58.5%), substance abuse issues (32.3%), mental health issues (24.6%), and immigration status (18.5%). In 38.8% of cases, the provider felt the surgery was preventable if medical factors leading to simple nephrectomy were properly addressed. Conclusions: Simple nephrectomy is a common surgery in the safety net hospital setting. Both medical and sociologic factors can lead to simple nephrectomy, and awareness of these factors can lead efforts to mitigate them. This review has led to the implementation of strategies to minimize occurrences of retained stents in our patients.

Original languageEnglish (US)
Pages (from-to)98-102
Number of pages5
JournalUrology
Volume149
DOIs
StatePublished - Mar 2021
Externally publishedYes

ASJC Scopus subject areas

  • Urology

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