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Predictive factors for the development of renal insufficiency following partial nephrectomy and subsequent renal function recovery: A multicenter retrospective study

Title
Predictive factors for the development of renal insufficiency following partial nephrectomy and subsequent renal function recovery: A multicenter retrospective study
Author
박성열
Keywords
carcinoma; complications; partial nephrectomy; renal cell; warm ischemia time
Issue Date
2019-05
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
MEDICINE, v. 98, NO 18, no. e15516
Abstract
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 ≥60 ml/minute/1.73 m 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 ≥1.1 mg/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 ˂1.1 mg/ml was an independent predictor. Age ≥60 years and preoperative creatinine ≥1.1 mg/ml were risk factors for renal insufficiency following PN. Patients with renal insufficiency whose preoperative creatinine was ˂1.1 mg/ml were likely to have renal function recovery.
URI
https://insights.ovid.com/crossref?an=00005792-201905030-00088https://repository.hanyang.ac.kr/handle/20.500.11754/111887
ISSN
0025-7974; 1536-5964
DOI
10.1097/MD.0000000000015516
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COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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