MP54-07 ROBOTIC PARTIAL NEPHRECTOMY IN PATIENTS WITH BASELINE CHRONIC KIDNEY DISEASE: A MULTICENTER PROPENSITY SCORE MATCHED ANALYSIS

Abstract

You have accessJournal of UrologyKidney Cancer: Localized III1 Apr 2014MP54-07 ROBOTIC PARTIAL NEPHRECTOMY IN PATIENTS WITH BASELINE CHRONIC KIDNEY DISEASE: A MULTICENTER PROPENSITY SCORE MATCHED ANALYSIS Ramesh Kumar, Jesse Sammon, Jihad Kaouk, Sam Bhayani, Michael Stifelman, Mohamad Allaf, Bartosz Kaczmarek, Ali Khalifeh, Michael Gorin, Ganesh Sivarajan, Youssef Tanagho, and Craig Rogers Ramesh KumarRamesh Kumar More articles by this author , Jesse SammonJesse Sammon More articles by this author , Jihad KaoukJihad Kaouk More articles by this author , Sam BhayaniSam Bhayani More articles by this author , Michael StifelmanMichael Stifelman More articles by this author , Mohamad AllafMohamad Allaf More articles by this author , Bartosz KaczmarekBartosz Kaczmarek More articles by this author , Ali KhalifehAli Khalifeh More articles by this author , Michael GorinMichael Gorin More articles by this author , Ganesh SivarajanGanesh Sivarajan More articles by this author , Youssef TanaghoYoussef Tanagho More articles by this author , and Craig RogersCraig Rogers More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1596AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Robot-assisted partial nephrectomy (RPN) in the setting of chronic kidney disease (CKD) presents additional challenges for preservation of renal function. We evaluate functional outcomes of RPN in patients with baseline CKD relative to patients undergoing RPN without baseline CKD. Methods A total of 1197 consecutive patients who underwent RPN at five academic institutions between 2007-2012 were identified. A total of 172 patients who underwent RPN with pre-existing CKD (estimated glomerular filtration rate [eGFR] 15-60 ml/min) were identified. Perioperative results of 121 patients were compared against propensity score matched controls without CKD (eGFR ≥ 60 ml/min). The propensity score matching considered the following variables: age, gender, race, BMI, ASA, CCI, ischemia time, multiple tumors, solitary kidney, tumor size and R.E.N.A.L. nephrometry score. Results After propensity score matching, patients with baseline CKD had a lower percent eGFR decrease at first follow-up (-5.1 vs. -10.9) that remained significant at a mean follow-up of 12.6 months (-2.8 vs. -9.1, p<0.05) and had less CKD upstaging (11.8% vs. 33.1%). CKD patients were less likely to be discharged in the first two postoperative days (39.7% vs. 56.2%, p=0.006) and had a higher overall rate of surgical complications (21.5 vs. 10.7%, p=0.007). Conclusions RPN in patients with baseline CKD is associated with a smaller decrease in renal function and less CKD upstaging compared to patients without baseline CKD, but a higher risk of surgical complications and a longer hospital stay. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e574 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Ramesh Kumar More articles by this author Jesse Sammon More articles by this author Jihad Kaouk More articles by this author Sam Bhayani More articles by this author Michael Stifelman More articles by this author Mohamad Allaf More articles by this author Bartosz Kaczmarek More articles by this author Ali Khalifeh More articles by this author Michael Gorin More articles by this author Ganesh Sivarajan More articles by this author Youssef Tanagho More articles by this author Craig Rogers More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...