SPARE（肾预后）评分被描述为比目前更广泛使用的RENAL和PADUA评分更易实施。我们的目标是比较SPARE评分在预测经肾腺恶性肿瘤手术（RAPN）后的肾功能预后方面的准确性。使用法国肾癌网络（UroCCR, NCT03293563）数据库进行了一项多中心回顾性研究。所有纳入研究的患者在2010年5月至2021年3月之间接受了RAPN治疗，肾肿瘤为cT1期。将SPARE与RENAL、PADUA和肿瘤大小进行比较，以预测术后急性肾损伤（AKI）、慢性肾脏疾病（CKD）升级、3-6个月随访期间新发CKD和三要素失败。使用单变量和多变量 logistic 回归模型评估不同评分和肿瘤大小预测肾功能预后的能力。根据我们的研究标准，共纳入1171例患者。平均术前肿瘤大小和估计肾小球滤过率（eGFR）分别为3.4±1.4 cm和85.8 mL/min/1.73 m2。总共有266例（22.7%）患者出现AKI，87例（7.4%）患者出现新发CKD，94例（8%）患者出现CKD升级，624例（53.3%）患者出现三要素失败。多变量分析显示，所有三个评分和肿瘤大小均是AKI、CKD新发、CKD升级和三要素失败的独立预测因子。在预测肾功能预后方面，所有三个评分和肿瘤大小之间没有显著差异。SPARE评分似乎是预测RAPN术后肾功能预后的有效替代方法。然而，在我们的研究中，肿瘤大小与评分在预测术后结果方面的准确性相当，因此在手术决策中似乎是逻辑上的选择。

The SPARE Nephrometry Score (NS) is described as easier to implement than the RENAL and PADUA NSs, currently more widely used. Our objective was to compare the accuracy of SPARE NS in predicting renal function outcomes following RAPN.A multicentric retrospective study was conducted using French kidney cancer network (UroCCR, NCT03293563) database. All patients included had RAPN for cT1 renal tumors between May 2010 and March 2021. SPARE was compared to RENAL, PADUA and Tumor Size to predict postoperative acute kidney injury (AKI), chronic kidney disease (CKD) upstaging, de novo CKD at 3-6 months follow-up and Trifecta failure. The ability of the different NSs and tumor size to predict renal function outcomes was evaluated using uni- and multivariate logistic regression models.According to our study criteria, 1171 patients were included. Mean preoperative tumor size and estimated glomerular filtration rate (eGFR) were 3.4±1.4 cm and 85.8 mL/min/1.73 m2. In total, 266 (22.7%), 87 (7.4%), 94 (8%), and 624 (53.3%) patients had AKI, de novo CKD, CKD upstaging, and Trifecta failure, respectively. In multivariate analysis, all three NSs and tumor size were independent predictors of AKI, CKD de novo, CKD upgrade and Trifecta failure. There was no significant difference between all three NS and tumor sizes in predicting renal function outcomes.SPARE Score seems to be a valid alternative to predict renal function outcomes after RAPN. Nevertheless, in our study, tumor size was as accurate as NSs in predicting postoperative outcomes and, therefore, seems to be the logical choice for surgical decisions.