Robotic Partial Nephrectomy in Patients with Chronic Kidney Disease: Objective Measurement of Short- and Long-Term Renal Functional Outcomes

Journal of Endourology
Charbel ChalouhyReza Ghavamian

Abstract

Minimal literature informs the use of robotic partial nephrectomy (RPN) in patients with chronic kidney disease (CKD). Therefore, we evaluated the renal functional outcomes in CKD patients undergoing RPN. We reviewed a prospective database of patients undergoing RPN 2010 to 2015 and identified 182 patients who had preoperative and postoperative nuclear renal scintigraphy (at 2 and 12 months postop). Preoperative and 12-month postoperative eGFR (mL/min/1.73 m2, by MDRD) were calculated. CKD was defined as eGFR ≤60 mL/min/1.73 m2 (CKD stages III and IV). Changes in creatinine, eGFR, and split function on mercaptoacetyltriglycine (MAG)-3 scan were compared by baseline CKD status. Correlations between pre- and postoperative eGFR were calculated. Of 182 patients, 30 (16.5%) had baseline CKD. Preoperative eGFR was 48.5 and 99.0 in CKD and non-CKD patients, respectively (p < 0.001). From preoperation to 12 months postoperation, eGFR decreased by 2.8 and 1.1 mL/min/1.73 m2, respectively (p = 0.6). On MAG-3 scan, the contribution of the surgical kidney to overall renal function decreased by 5.0% and 4.8% (p = 0.9) in the CKD and non-CKD cohorts, respectively. When comparing renal scans at 2 and 12 months postoperation, in both groups th...Continue Reading

References

Dec 25, 2002·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Josef CoreshAndrew S Levey
Sep 24, 2004·The New England Journal of Medicine·Alan S GoChi-yuan Hsu
Jun 14, 2008·Biostatistics·Thomas A Louis, Scott L Zeger
Nov 16, 2010·The Journal of Urology·Melanie A ClarkScott E Eggener
Apr 22, 2014·The Journal of Urology·Sevag DemirjianSteven C Campbell
Mar 21, 2016·Journal of Robotic Surgery·Lorenzo G LucianiGianni Malossini

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