"At-risk" kidney: How surgical factors influence renal functional preservation after partial nephrectomy

International Journal of Urology : Official Journal of the Japanese Urological Association
Julien DagenaisJihad H Kaouk

Abstract

To investigate the influence of surgical modifiable factors on chronic kidney disease upstaging in a contemporary cohort of patients with normal and "at-risk" kidneys undergoing partial nephrectomy. We reviewed 778 consecutive patients with (n = 634)/without (n = 144) chronic kidney disease or risk factors for chronic kidney disease in our institutional partial nephrectomy database. Chronic kidney disease upstaging was assessed using glomerular filtration rate measurements preoperatively and at 3-12 months postoperatively. Using a multivariate logistic regression, baseline clinicodemographic factors, and the operative measurements of excisional volume loss and warm and cold ischemia time on rates of chronic kidney disease upstaging were determined. Marginal effects were used to analyze the impact of ischemia time and generate interaction curves. Chronic kidney disease/risk factors for chronic kidney disease had equivalent rates of chronic kidney disease upstaging as the healthy kidney cohort (31.5% vs 38.2%, P = 0.15). Of the entire cohort, 2.8% were upstaged to stage IV-V chronic kidney disease. Multivariate analysis found a significant association between chronic kidney disease upstaging and excisional volume loss in both coh...Continue Reading

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Citations

Mar 1, 2019·International Journal of Urology : Official Journal of the Japanese Urological Association·Jun Teishima, Akio Matsubara
Jul 30, 2020·Aktuelle Urologie·Caroline Eich, Markus Giessing
Oct 9, 2021·Current Urology Reports·P MacekA R Rodriguez

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