MP59-06 LONGITUDINAL CHANGE OF RENAL PARENCHYMAL VOLUME PRESERVED AFTER PARTIAL NEPHRECTOMY IN PATIENTS WITH PREEXISTING CHRONIC KIDNEY DISEASE

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V (MP59)1 Sep 2021MP59-06 LONGITUDINAL CHANGE OF RENAL PARENCHYMAL VOLUME PRESERVED AFTER PARTIAL NEPHRECTOMY IN PATIENTS WITH PREEXISTING CHRONIC KIDNEY DISEASE Masaki Warabino, Hajime Tanaka, Shohei Fukuda, Hiroshi Fukushima, Sho Uehera, Yosuke Yasuda, Soichiro Yoshida, Minato Yokoyama, Yoh Matsuoka, and Yasuhisa Fujii Masaki WarabinoMasaki Warabino More articles by this author , Hajime TanakaHajime Tanaka More articles by this author , Shohei FukudaShohei Fukuda More articles by this author , Hiroshi FukushimaHiroshi Fukushima More articles by this author , Sho UeheraSho Uehera More articles by this author , Yosuke YasudaYosuke Yasuda More articles by this author , Soichiro YoshidaSoichiro Yoshida More articles by this author , Minato YokoyamaMinato Yokoyama More articles by this author , Yoh MatsuokaYoh Matsuoka More articles by this author , and Yasuhisa FujiiYasuhisa Fujii More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002094.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Functional outcomes after partial nephrectomy (PN) depend on the ipsilateral (ipsi-) renal parenchymal volume (RPV) preserved. New-baseline RPV early after PN has been widely studied; however, a longitudinal change of RPV beyond the new baseline has not been well examined. In this study, we investigated the annual change of eGFR after PN as well as ipsi-RPV in comparison to the contralateral (contra-) RPV in patients with preexisting chronic kidney disease (CKD). METHODS: 76 patients with preoperative eGFR <60 mL/min/1.73m2 who received PN for an unilateral primary renal tumor were analyzed. Patients with solitary kidney, metastatic disease, or renal recurrences developed after PN were excluded. Ipsi- and contra-RPVs before/after PN were measured on CT images. %RPV was defined as RPV after PN normalized by that before PN. The new baseline was defined as 6-12 months after PN and the annual changes of eGFR and %RPVs after the new baseline were assessed using linear mixed model. RESULTS: Median age was 66 and 60 patients (76%) were male. 48 (63%), 11 (15%), and 8 (11%) had hypertension, diabetes, and cardiovascular diseases, respectively. Median tumor size was 2.6 cm and R.E.N.A.L. was 7. Acute kidney injury (AKI) occurred in 13 patients (17%) after PN. Median follow-up was 4.6 years. Median eGFR was 53.2 before PN; it decreased to 50.7 at the new baseline and gradually declined at -0.99/year (95%CI: -1.21, -0.77) afterward. Median ipsi- and contra-RPVs before PN were 124 cm3 and 129 cm3, respectively. After PN, median %ipsi-RPV was 81% at the new baseline and declined at -1.05%/year (95%-CI: -1.31, -0.79) afterward, while %contra-RPV declined at -0.72%/year (-1.05, -0.37). The decrease of %ipsi-RPV from the new baseline to the last follow-up was larger than %contra-RPV (median, -4.2% vs. -1.2%; p=0.001). In multivariable analysis, cardiovascular diseases, larger tumor size, and AKI after PN were associated with a significant decrease of %ipsi-RPV from the new baseline. CONCLUSIONS: In patients with preexisting CKD, eGFR and RPVs gradually declined from the new baseline after PN. The longitudinal decrease of RPV was more pronounced in the operated kidney, which could be affected by cardiovascular morbidities and the extent of surgical manipulation during PN. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1031-e1032 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Masaki Warabino More articles by this author Hajime Tanaka More articles by this author Shohei Fukuda More articles by this author Hiroshi Fukushima More articles by this author Sho Uehera More articles by this author Yosuke Yasuda More articles by this author Soichiro Yoshida More articles by this author Minato Yokoyama More articles by this author Yoh Matsuoka More articles by this author Yasuhisa Fujii More articles by this author Expand All Advertisement Loading ...