MP63-17 TRENDS OF ACUTE KIDNEY INJURY AFTER RADICAL OR PARTIAL NEPHRECTOMY FOR RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyKidney Cancer: Surgical Therapy IV1 Apr 2015MP63-17 TRENDS OF ACUTE KIDNEY INJURY AFTER RADICAL OR PARTIAL NEPHRECTOMY FOR RENAL CELL CARCINOMA Marianne Schmid, Praful Rafi, Nandita Krishna, Akshay Sood, Deepansh Dalela, Felix Chun, Adam Kibel, Mani Menon, Paul Nguyen, Toni Choueiri, Margit Fisch, and Quoc-Dien Trinh Marianne SchmidMarianne Schmid More articles by this author , Praful RafiPraful Rafi More articles by this author , Nandita KrishnaNandita Krishna More articles by this author , Akshay SoodAkshay Sood More articles by this author , Deepansh DalelaDeepansh Dalela More articles by this author , Felix ChunFelix Chun More articles by this author , Adam KibelAdam Kibel More articles by this author , Mani MenonMani Menon More articles by this author , Paul NguyenPaul Nguyen More articles by this author , Toni ChoueiriToni Choueiri More articles by this author , Margit FischMargit Fisch More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2349AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal cell carcinoma (RCC) patients treated with radical (RN) or partial nephrectomy (PN) are at risk of postoperative acute kidney injury (AKI). We sought to investigate the incidence, trends and predictors of postoperative AKI in a large cohort of RCC patients treated with RN or PN. METHODS Between January 1998 and December 2010, patients who underwent RN or PN for RCC were identified within the Nationwide Inpatient Sample. Incidence and temporal trends of AKI were analyzed. Association between AKI and in-hospital complications, mortality, length of stay and charges were evaluated using logistic regression models adjusted for clustering. Finally, predictors of AKI were identified using multivariable logistic regression analysis. RESULTS Overall, 253,222 (78.1%) and 71,176 (21.9%) patients respectively underwent RN and PN. Of these, 17,828 (5.5%) experienced AKI. Incidence of AKI following RN/PN significantly increased over the period (estimated annual percentage change [EAPC]=16.6% [17.7-18.8], p<0.001). Although higher overall incidence of AKI was observed after RN compared to PN (RN: 0.38/100,000 vs. PN: 0.09/100,000), the rate of increase in AKI over time was greater following PN compared to RN (RN: EAPC=15.5% [16.8-17.9]; PN: EAPC=19.0% [22.2-25.5], p<0.001) following PN. Incidence of any complication, mortality, prolonged hospital stay and excessive hospital costs were significantly greater in patients who experienced AKI, irrespective of the procedure (RN or PN) [all p<0.001]. Predictors of AKI after RN/PN included older age, higher comorbid status, higher chronic kidney disease stage and surgery at urban hospitals (all p<0.05). CONCLUSIONS There is rising incidence of AKI after RN and PN. Increasing awareness of AKI incidence, identification of patients at risk prior to surgery, early postoperative AKI diagnosis, collaboration with nephrologists, implementation of reno-protective strategies, and long-term renal functional follow-up are warranted in these patients to provide improved outcomes and reduce costs. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e796 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marianne Schmid More articles by this author Praful Rafi More articles by this author Nandita Krishna More articles by this author Akshay Sood More articles by this author Deepansh Dalela More articles by this author Felix Chun More articles by this author Adam Kibel More articles by this author Mani Menon More articles by this author Paul Nguyen More articles by this author Toni Choueiri More articles by this author Margit Fisch More articles by this author Quoc-Dien Trinh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...