Predictive factors for the development of renal insufficiency following partial nephrectomy and subsequent renal function recovery A multicenter retrospective study
- 주제(키워드) carcinoma , complications , partial nephrectomy , renal cell , warm ischemia time
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Lee, Kwang Suk; Chung, Byung Ha; Koo, Kyo Chul] Yonsei Univ, Coll Med, Gangnam Severance Hosp, Dept Urol, Seoul, South Korea; [Kim, Dae Keun] CHA Univ, Dept Urol, CHA Seoul Stn Med Ctr, Pochon, South Korea; [Kim, Kwang Hyun] Ewha Womans Univ, Coll Med, Dept Urol, Seoul, South Korea; [Bang, Woo Jin; Cho, Jin Seon] Hallym Univ, Coll Med, Dept Urol, Chunchon, South Korea; [Kim, Hyung Joon] Konyang Univ, Coll Med, Dept Urol, Daejeon, South Korea; [Park, Sung Yul] Hanyang Univ, Coll Med, Dept Urol, Seoul, South Korea; [Rha, Koon Ho] Yonsei Univ, Coll Med, Shinchon Severance Hosp, Dept Urol, Seoul, South Korea
- 등재 SCIE, SCOPUS
- OA유형 Green Published, gold
- 발행기관 LIPPINCOTT WILLIAMS & WILKINS
- 발행년도 2019
- URI http://www.dcollection.net/handler/ewha/000000160399
- 본문언어 영어
- Published As http://dx.doi.org/10.1097/MD.0000000000015516
- PubMed https://pubmed.ncbi.nlm.nih.gov/31045843
초록/요약
Patients who undergo partial nephrectomy (PN) may exhibit renal function insufficiency, and a subset of these patients achieves renal function recovery. We evaluated the predictors of renal insufficiency and subsequent renal function recovery following PN. Data on 393 patients who underwent PN for solid renal tumors between March 2001 and November 2013, obtained from 6 institutions, were retrospectively reviewed. Renal insufficiency was defined as new onset of chronic kidney disease stage >= 3 postoperatively on the second of 2 consecutive tests. Renal function recovery was defined as an estimated glomerular filtration rate >= 60ml/minute/1.73m(2) following renal insufficiency. Tumor complexity was stratified according to the RENAL classification system. The median (interquartile range) age, tumor size, and follow-up period were 53 (45-63) years, 2.6 (1.9-3.8) cm, and 36 (12-48) months, respectively. Tumors were of low complexity in 258/393 (65.6%) of cases. Renal insufficiency developed in 54/393 (13.5%) patients, in which age >= 60 years and preoperative creatinine >= 1.1mg/ml were independent predictors. Tumor complexity, clamp type, and operative method were not significant prognostic factors. Among patients with newly developed renal insufficiency, 18/54 (33.3%) patients exhibited renal function recovery within a median period of 18 months, of which preoperative creatinine <1.1mg/ml was an independent predictor. Age >= 60 years and preoperative creatinine >= 1.1mg/ml were risk factors for renal insufficiency following PN. Patients with renal insufficiency whose preoperative creatinine was <1.1mg/ml were likely to have renal function recovery.
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