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

Authors
 Kwang Lee  ;  Dae Kim  ;  Kwang Kim  ;  Woo Bang  ;  Hyung Kim  ;  Sung Park  ;  Koon Rha  ;  Byung Chung  ;  Jin Cho  ;  Kyo Koo 
Citation
 MEDICINE, Vol.98(18) : e15516, 2019 
Journal Title
MEDICINE
ISSN
 0025-7974 
Issue Date
2019
MeSH
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
Abstract
Patients who undergopartialnephrectomy(PN) may exhibitrenalfunctioninsufficiency, and a subset of these patients achievesrenalfunctionrecovery. We evaluated the predictors ofrenalinsufficiencyandsubsequentrenalfunctionrecoveryfollowingPN. Data on 393 patients who underwent PN for solidrenaltumors between March 2001 and November 2013, obtained from 6 institutions, were retrospectively reviewed.Renalinsufficiencywas defined as new onset of chronic kidney disease stage ≥3 postoperatively on the second of 2 consecutive tests.Renalfunctionrecoverywas defined as an estimated glomerular filtration rate ≥60 ml/minute/1.73 mfollowingrenalinsufficiency. Tumor complexity was stratified according to theRENALclassification 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.Renalinsufficiencydeveloped 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 prognosticfactors. Among patients with newly developedrenalinsufficiency, 18/54 (33.3%) patients exhibitedrenalfunctionrecoverywithin 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 riskfactorsforrenalinsufficiencyfollowingPN. Patients withrenalinsufficiencywhose preoperative creatinine was <1.1 mg/ml were likely to haverenalfunctionrecovery.
Files in This Item:
T201902232.pdf Download
DOI
10.1097/MD.0000000000015516
Appears in Collections:
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
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170410
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