MP73-19 PREOPERATIVE PROTEINURIA PREDICTS INCREASED RATES OF ACUTE KIDNEY INJURY AFTER PARTIAL NEPHRECTOMY

Abstract

You have accessJournal of UrologyKidney Cancer: Basic Research & Pathophysiology III1 Apr 2017MP73-19 PREOPERATIVE PROTEINURIA PREDICTS INCREASED RATES OF ACUTE KIDNEY INJURY AFTER PARTIAL NEPHRECTOMY Önder Kara, Matthew J. Maurice, Pascal Mouracade, Ercan Malkoç, Julien Dagenais, Ryan J. Nelson, Jaya Sai Chavali, and Jihad H. Kaouk Önder KaraÖnder Kara More articles by this author , Matthew J. MauriceMatthew J. Maurice More articles by this author , Pascal MouracadePascal Mouracade More articles by this author , Ercan MalkoçErcan Malkoç More articles by this author , Julien DagenaisJulien Dagenais More articles by this author , Ryan J. NelsonRyan J. Nelson More articles by this author , Jaya Sai ChavaliJaya Sai Chavali More articles by this author , and Jihad H. KaoukJihad H. Kaouk More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.3364AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Proteinuria reflects structural damage to glomeruli and/or renal tubules and is considered an important prognostic indicator of chronic kidney disease (CKD) and possibly acute kidney injury (AKI). We examined the significance of preoperative proteinuria on postoperative kidney function after robotic partial nephrectomy (RPN). METHODS We retrospectively reviewed 1121 consecutive RPN cases at a single academic center from 2006 to 2016. Patients without pre-existing CKD (eGFR≥60 mL/min/1.73m2) who had a urinalysis within 1-month prior to RPN were included. The cohort was categorized by the presence or absence of preoperative proteinuria (≥30 mg/dL), and groups were compared in terms of clinical and functional outcomes. The incidence of AKI was assessed using RIFLE criteria. Univariate and multivariable models were used to identify predictors of postoperative AKI. RESULTS Of 947 patients, 97 (10.5%) had preoperative proteinuria. Characteristics associated with preoperative proteinuria included non-white race (p<0.01), preoperative diabetes (p<0.01) and hypertension (HTN) (p<0.01), higher ASA (p<0.01), higher BMI (p<0.01), and higher Charlson score (p<0.01). The incidence of AKI was higher in patients with preoperative proteinuria (10.3% vs. 4.6%, p=0.01). The median eGFR preservation measured within one month after surgery was lower (83.6% vs. 91%, p=0.04) in those with proteinuria; however, there were no significant differences by 3 months after surgery or last follow-up visit. Independent predictors of AKI were high BMI (p<0.01), longer ischemia time (p<0.01), and preoperative proteinuria (p=0.02). CONCLUSIONS Preoperative proteinuria by urine dipstick is an independent predictor of postoperative AKI after RPN. This test may be used to identify patients, especially those without overt CKD, who are at increased risk for developing AKI after RPN. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e971-e972 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Önder Kara More articles by this author Matthew J. Maurice More articles by this author Pascal Mouracade More articles by this author Ercan Malkoç More articles by this author Julien Dagenais More articles by this author Ryan J. Nelson More articles by this author Jaya Sai Chavali More articles by this author Jihad H. Kaouk More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...