MP59-17 RECOVERY IN RENAL FUNCTION AFTER RADICAL NEPHRECTOMY AND ITS NEGATIVE PREDICTIVE FACTORS : A MULTICENTER LONGITUDINAL STUDY

Abstract

You have accessJournal of UrologyKidney Cancer: Surgical Therapy III1 Apr 2015MP59-17 RECOVERY IN RENAL FUNCTION AFTER RADICAL NEPHRECTOMY AND ITS NEGATIVE PREDICTIVE FACTORS : A MULTICENTER LONGITUDINAL STUDY Naoko Kawamura Naoko KawamuraNaoko Kawamura More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2177AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In this study, we investigated the longitudinal change in renal function after RN in Japanese patients,and examined its difference in terms of the presence or absence of preoperative chronic kidney disease(CKD). In addition, we examined the risk factors of severe deterioration in renal function. METHODS Of 1035 patients with renal tumors undergoing RN between 1994 and 2011,those with metastases, bilateral renal tumors, end-stage kidney disease, and insufficient follow-up (< 1 year) were excluded. Thus,703 patients were enrolled in this study. Clinical characteristics and longitudinal serum creatinine data were collected for each patient. Patients were divided into two groups according to preoperative estimated glomerular filtration rate(eGFR). The CKD group consisted of patients with preoperative eGFR<60 ml/min/1.73 m2,and the others comprised the non-CKD group. Mean eGFR value at each year during the 8-year follow-up period was plotted and compared by analysis of variance and the Kruskal-Wallis test. Uni-and multivariate analyses were carried out to identify the risk factors associated with a greater than 50% eGFR decrease at latest follow-up. RESULTS Median age and preoperative eGFR was 64 years old and 69.6 ml/min/1.73 m2,respectively. Of the patients, 42.8%,15.3%,and 15.8% had hypertension, diabetes mellitus(DM),and cardiovascular disease. During the median follow-up of 62 months,9 patients eventually required dialysis.eGFR after RN improved gradually over a period of 8 years. This recovery was observed even in the CKD group (Fig.1). At latest follow-up, a greater than 50% eGFR decrease was observed in 58 patients. Uni-and multivariate analyses demonstrated that the presence of DM and older age were independent risk factors of a greater than 50% eGFR decrease. In contrast to patients without DM,the longitudinal recovery of renal function was not observed in patients with DM. CONCLUSIONS The current study demonstrated that the renal function of Japanese patients after RN recovered slightly during the 8-year follow-up period, regardless of the presence or absence of preoperative CKD. Particularly in patients with DM or older age,however,careful consideration of the application of RN is required. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e736 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Naoko Kawamura More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...