MP59-09 FUNCTIONAL CHANGE OF CONTRALATERAL KIDNEY AFTER PARTIAL NEPHRECTOMY USING DIETHYLENE TRIAMINE PENTA-ACETIC ACID (DTPA) RENAL SCINTIGRAPHY: LONG TERM ANALYSIS

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV1 Apr 2017MP59-09 FUNCTIONAL CHANGE OF CONTRALATERAL KIDNEY AFTER PARTIAL NEPHRECTOMY USING DIETHYLENE TRIAMINE PENTA-ACETIC ACID (DTPA) RENAL SCINTIGRAPHY: LONG TERM ANALYSIS Se Young Choi, Jeman Ryu, Jae Hyeon Han, Wonchul Lee, Han Kyu Chae, Sangjun Yoo, Dalsan You, In Gab Jeong, Cheryn Song, Bumsik Hong, Hanjong Ahn, and Choung-Soo Kim Se Young ChoiSe Young Choi More articles by this author , Jeman RyuJeman Ryu More articles by this author , Jae Hyeon HanJae Hyeon Han More articles by this author , Wonchul LeeWonchul Lee More articles by this author , Han Kyu ChaeHan Kyu Chae More articles by this author , Sangjun YooSangjun Yoo More articles by this author , Dalsan YouDalsan You More articles by this author , In Gab JeongIn Gab Jeong More articles by this author , Cheryn SongCheryn Song More articles by this author , Bumsik HongBumsik Hong More articles by this author , Hanjong AhnHanjong Ahn More articles by this author , and Choung-Soo KimChoung-Soo Kim More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1825AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Partial nephrectomy aims to maintain renal function by nephron sparing. However, the functional change of contralateral kidney remains to be known. We evaluated the functional change in contralateral kidney using DTPA renal scan and determined the predicting factors of contralateral kidney function after partial nephrectomy. METHODS From 2001 to 2012, 699 patients underwent partial nephrectomy and we performed DTPA renal scan before and after surgery in all patients to assess the exact renal function of each kidney. Patients were divided into 3 groups according to initial contralateral glomerular filtration rate (GFR) (group 1: <30ml/min/1.73m2, group 2: 30~45ml/min/1.73m2, and group 3: ≥45ml/min/1.73m2). We evaluated separate renal functions using DTPA up to 5 year after surgery. Logistic regression analysis was used to identify the factors associated with increased GFR of contralateral kidney. Kaplan-Meier method was used for overall survival. Median follow-up period was 45.1 month. RESULTS Patients of group 1 were older age (64.2±9.8 vs 55.0±11.0 vs 48.0±9.5, p<0.001), more hypertension history (59.5% vs 39.3% vs 20.9%, p<0.001), worse American society of anesthesiologists (ASA) score (≥2; 94.0% vs 89.5% vs 80.2%, p<0.001), and shorter ischemic time (19.9±8.0 vs 22.3±8.7 vs 22.8±8.9, p=0.025) among three groups (respectively). Tumor size, resected weight, RENAL nephrometry score and ischemic type were not different among three groups (p=0.293, p=0.255, p=0.582 and p=0.967, respectively). The mean ipsilateral GFR changes were -7.5%, -1.6%, and -21.2% in group 1, 2, and 3, respectively and contralateral GFR changes were 33.9%, 19.9%, and 7.3% in group 1, 2, and 3, respectively at 5 year after partial nephrectomy. On multivariable analysis, ASA score (OR 0.54, 95% confidence interval [CI] 0.31-0.92 p=0.0277) and preoperative contralateral GFR (OR 0.97, 95% CI 0.95-0.99 p=0.0011) were the significant predictive factors for increased GFR of contralateral kidney within 5 years. 5 year overall survival rates were 86.1%, 93.1% and 97.4% in group 1, 2, 3, respectively. CONCLUSIONS Contralateral kidney compensated for the functional loss of ipsilateral kidney. The increase of GFR in contralateral kidney is more prominent in healthy patients with decreased contralateral renal function. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e784 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Se Young Choi More articles by this author Jeman Ryu More articles by this author Jae Hyeon Han More articles by this author Wonchul Lee More articles by this author Han Kyu Chae More articles by this author Sangjun Yoo More articles by this author Dalsan You More articles by this author In Gab Jeong More articles by this author Cheryn Song More articles by this author Bumsik Hong More articles by this author Hanjong Ahn More articles by this author Choung-Soo Kim More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...