The impact of significant loss of renal mass resultant from kidney cancer surgery is not fully known. Large clinical studies demonstrate that loss of kidney function correlates with an increased incidence of hospitalizations, cardiovascular events, and all-cause mortality. Patients with renal cell carcinoma (RCC) tend to be older, often have co-morbid conditions associated with lower baseline kidney function, and may be particularly sensitive to further loss of kidney function following kidney cancer surgery. Hence, there is a great need to determine the comparative effectiveness of alternative surgical approaches for RCC on kidney function and downstream clinical outcomes. The goal of this award period is for Dr. Leppert to achieve complete independence as an investigator in urologic health services research and expertise in RCC clinical outcomes. He will receive extensive training through the Clinical Research Track in the Graduate Program in Epidemiology at Stanford University, and through the specific aims of the project. The broad objective of this study is to determine the effect of kidney cancer surgery on kidney function and outcomes associated with chronic kidney disease (CKD) such as end-stage renal disease (ESRD), cardiovascular events, hospitalizations, and mortality.
The specific aims of the project are to 1) establish an electronic data registry of persons that underwent kidney cancer surgery within the Veterans Affairs (VA) health care system, 2) characterize the change of kidney function due to specific types of kidney cancer surgery, and 3) to correlate the type of kidney cancer surgery received and post-operative kidney function with the risk of ESRD, conditions associated with CKD, cardiovascular events, hospitalizations, and all-cause mortality among RCC patients in the VA health care system. Ultimately, comparing these surgical strategies can provide opportunities to improve care for patients diagnosed with RCC.

Public Health Relevance

The impact of kidney cancer surgery on chronic kidney disease and its associated clinical outcomes is not fully known. Comparing the effect of kidney cancer surgery on kidney function will help inform treatment decisions and provide opportunities to improve care and clinical outcomes for patients diagnosed with kidney cancer.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
Application #
Study Section
Special Emphasis Panel (ZDK1-GRB-G (M2))
Program Officer
Rankin, Tracy L
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Stanford University
Schools of Medicine
United States
Zip Code
Barbosa, Philip V; Thomas, I-Chun; Srinivas, Sandy et al. (2016) Overall Survival in Patients with Localized Prostate Cancer in the US Veterans Health Administration: Is PIVOT Generalizable? Eur Urol 70:227-30
Leppert, John T; Mittakanti, Harsha R; Thomas, I-Chun et al. (2016) Contemporary Use of Partial Nephrectomy: Are Older Patients With Impaired Kidney Function Being Left Behind? Urology :
Lee, J Joy; Thomas, I-Chun; Nolley, Rosalie et al. (2015) Biologic differences between peripheral and transition zone prostate cancer. Prostate 75:183-90
Weinberg, Aviva E; Leppert, John T; Elliott, Christopher S (2015) Biochemical Measures of Diabetes are Not Independent Predictors of Urinary Incontinence in Women. J Urol 194:1668-74
Conti, Simon L; Thomas, I-Chun; Hagedorn, Judith C et al. (2014) Utilization of cytoreductive nephrectomy and patient survival in the targeted therapy era. Int J Cancer 134:2245-52
Liu, Jen-Jane; Leppert, John T; Maxwell, Bryan G et al. (2014) Trends and perioperative outcomes for laparoscopic and robotic nephrectomy using the National Surgical Quality Improvement Program (NSQIP) database. Urol Oncol 32:473-9
Leppert, John T; Hanley, Janet; Wagner, Todd H et al. (2014) Utilization of renal mass biopsy in patients with renal cell carcinoma. Urology 83:774-9
Weinberg, Aviva E; Patel, Chirag J; Chertow, Glenn M et al. (2014) Diabetic severity and risk of kidney stone disease. Eur Urol 65:242-7
Weinberg, Aviva E; Eisenberg, Michael; Patel, Chirag J et al. (2013) Diabetes severity, metabolic syndrome, and the risk of erectile dysfunction. J Sex Med 10:3102-9
Ngo, Tin C; Hurley, Michael P; Thong, Alan E et al. (2013) Estimating the risk of chronic kidney disease after nephrectomy. Can J Urol 20:7035-41

Showing the most recent 10 out of 12 publications