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

 Kwang Lee  ;  Dae Kim  ;  Kwang Kim  ;  Woo Bang  ;  Hyung Kim  ;  Sung Park  ;  Koon Rha  ;  Byung Chung  ;  Jin Cho  ;  Kyo Koo 
 MEDICINE, Vol.98(18) : e15516, 2019 
Journal Title
Issue Date
Age Factors ; Creatinine/blood ; Female ; Humans ; Kidney/physiopathology ; Kidney/surgery ; Kidney Neoplasms/blood ; Kidney Neoplasms/physiopathology ; Kidney Neoplasms/surgery ; Male ; Middle Aged ; Nephrectomy/adverse effects ; Nephrectomy/methods ; Postoperative Complications/etiology ; Postoperative Complications/physiopathology ; Preoperative Period ; Recovery of Function ; Renal Insufficiency/etiology ; Renal Insufficiency/physiopathology ; Retrospective Studies ; Risk Factors
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.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Lee, Kwang Suk(이광석) ORCID logo https://orcid.org/0000-0002-7961-8393
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
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