Ebbing J, et al. - Researchers assessed the short- and long-term changes in estimated glomerular filtration rate (eGFR) following ischaemic or zero-ischaemic open nephron-sparing surgery (NSS) [ONSS] vs laparoscopic NSS (LNSS) for renal cell cancer (RCC). They also investigated prognostic factors for postoperative acute kidney injury (AKI) and chronic kidney disease (CKD) stage ≥3. They retrospectively analyzed data of 444 patients (211 LNSS, 233 ONSS), including 57 zero-ischaemic cases. They predicted relative changes in renal function by using multiple regression models. The link between ischaemia time (IT) and relative changes in renal function was assessed using natural cubic splines. IT was identified as a significant risk factor for AKI. Regarding the effect of IT, they noted that not always short-term influence was linear, and baseline eGFR also determined the effect. ONSS was found to be related to the development of AKI, unlike LNSS. Findings led to the recommendation for applying a clampless NSS technique or at least the shortest possible IT to attenuate the risk of short-time impairment of the renal function, which might prevent AKI, particularly regarding patients with baseline eGFR category ≥G3.