NEPHRECTOMY - CHANGING INDICATIONS, 1960-1990

Objective To review the indications for nephrectomy over the period 19 60-1990.Patients and methods A total of 1470 nephrectomies were perfor med (excluding transplant-related nephrectomies) over this period. Dat a were collected by means of a pathology report review and the indicat ions were classified according to aetiology. Results The total number of nephrectomies performed has not significantly changed over this 31- year period. There was a significant decrease in the number of partial nephrectomies performed and an increase in the number of nephrectomie s performed for tumour. This change was equally distributed between bo th renal adenocarcinomas and transitional cell tumours. The number of nephrectomies for chronic pyelonephritis decreased over this period. T he change seen was not as great as might have been anticipated is view of the advent of modern antibiotics. Nephrectomies performed for tube rculosis decreased, although this change was not established until the 1980s. In the 1960s and early 1970s, most tuberculous nephrectomies w ere performed in patients from the native community. By the 1980s, mos t patients in this category were from the ethnic Asian immigrant commu nity. Nephrectomy rates for polycystic kidney and trauma remained unch anged. Conclusions Despite changes in the investigation and management of renal tract pathologies, which contributed to a change in the indi cations for nephrectomy, the overall number of nephrectomies performed has remained constant over a 31-year period.