OP2-08 HYPERURICEMIA IS ASSOCIATED WITH DE NOVO CHRONIC KIDNEY DISEASE AFTER PARTIAL NEPHRECTOMY

Abstract

You have accessJournal of UrologyOutstanding Posters: Benign Disease1 Apr 2014OP2-08 HYPERURICEMIA IS ASSOCIATED WITH DE NOVO CHRONIC KIDNEY DISEASE AFTER PARTIAL NEPHRECTOMY Jason Woo, Hak Lee, Song Wang, Michael Liss, Nishant Patel, Ramzi Jabaji, Fuad Elkhoury, Michelle McDonald, Kerrin Palazzi, Reza Mehrazin, Anthony Patterson, and Ithaar Derweesh Jason WooJason Woo More articles by this author , Hak LeeHak Lee More articles by this author , Song WangSong Wang More articles by this author , Michael LissMichael Liss More articles by this author , Nishant PatelNishant Patel More articles by this author , Ramzi JabajiRamzi Jabaji More articles by this author , Fuad ElkhouryFuad Elkhoury More articles by this author , Michelle McDonaldMichelle McDonald More articles by this author , Kerrin PalazziKerrin Palazzi More articles by this author , Reza MehrazinReza Mehrazin More articles by this author , Anthony PattersonAnthony Patterson More articles by this author , and Ithaar DerweeshIthaar Derweesh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2558AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Uric acid elevation has been associated with an increased risk of chronic kidney disease (CKD) in the medical setting. We investigated the relationship between uric acid levels and renal function in patients with cortical renal masses undergoing partial nephrectomy (PN). METHODS A multi-institutional retrospective study was performed of patients who underwent PN for renal cortical neoplasms, and who had preoperative and postoperative serum uric acid determined at 6 months follow-up. Data was analyzed between two groups: Patients who had hyperuricemia (>7mg/dL for males, >5.7 mg/dL for females) at 6 months follow up and patients with normal uric acid levels at 6 months follow up. Demographics, RENAL nephrometry score, peri-operative outcomes, and renal function were analyzed and compared. Rate of de novo estimated glomerular filtration rate<60 mL/min/1.73 m2 (eGFR at most recent follow-up, MDRD equation) was primary outcome. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were calculated for association of hyperuricemia with de novo eGFR <60. Multivariable analysis (MVA) was performed to identify factors associated with de novo eGFR<60 at last follow-up. RESULTS 298 patients were identified with appropriate uric acid data from patients undergoing PN at UC San Diego Health System and the University of Tennessee Health Science Center (8/2005-8/2013). 112 had postoperative hyperuricemia and 186 had normal uric acid levels. Demographics, median ischemia time (normal uric acid 23 minutes vs. hyperuricemia 24 minutes, p=0.1) and tumor size (normal uric acid 3.4 cm vs. hyperuricemia 3.5 cm, p=0.153) were similar. More patients in the hyperuricemia group were male, non-Caucasian, obese with BMI >30, hypertensive and smokers (p <0.05). Rate of de novo eGFR<60 was significantly higher with hyperuricemia vs. normal uric acid levels (20.5% vs. 4.3% p<0.001). Hyperuricemia had sensitivity 74.2%, specificity 66.7%, PPV 20.5%, and NPV 95.7% for de novo eGFR<60. MVA for de novo eGFR<60 demonstrated hyperuricemia (OR 14.9, p<0.001) and increasing RENAL nephrometry score (OR 3.5, p=0.017) as independent factors associated with development of de novo eGFR<60. CONCLUSIONS Uric acid elevation postoperatively is independently associated with renal functional degeneration after PN. Further studies are requisite to clarify the etiology of this association. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e390 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Jason Woo More articles by this author Hak Lee More articles by this author Song Wang More articles by this author Michael Liss More articles by this author Nishant Patel More articles by this author Ramzi Jabaji More articles by this author Fuad Elkhoury More articles by this author Michelle McDonald More articles by this author Kerrin Palazzi More articles by this author Reza Mehrazin More articles by this author Anthony Patterson More articles by this author Ithaar Derweesh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...