OP2-12 MEASURING THE IMPACT OF MEDICAL CHRONIC KIDNEY DISEASE AND DIABETES MELLITUS ON RENAL FUNCTIONAL DECLINE FOLLOWING RADICAL NEPHRECTOMY AND NEPHRON-SPARING SURGERY FOR RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyOutstanding Posters: Benign Disease1 Apr 2014OP2-12 MEASURING THE IMPACT OF MEDICAL CHRONIC KIDNEY DISEASE AND DIABETES MELLITUS ON RENAL FUNCTIONAL DECLINE FOLLOWING RADICAL NEPHRECTOMY AND NEPHRON-SPARING SURGERY FOR RENAL CELL CARCINOMA Adiel E. Mamut, Neal E. Rowe, Philippe D. Violette, Fulan Cui, and Patrick P.W. Luke Adiel E. MamutAdiel E. Mamut More articles by this author , Neal E. RoweNeal E. Rowe More articles by this author , Philippe D. ViolettePhilippe D. Violette More articles by this author , Fulan CuiFulan Cui More articles by this author , and Patrick P.W. LukePatrick P.W. Luke More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2562AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The risk factors for medical chronic kidney disease are well established, however, the impact of such factors in a conjunction with surgical kidney disease have been the source of recent debate. The goal of our study was to identify risk factors for renal functional decline following extirpative renal surgery, and to establish the impact of these factors on glomerular filtration rate (GFR) reduction. METHODS We present a retrospective cohort study of 344 consecutive patients who underwent surgery for a renal mass at a tertiary care center between 2002 and 2010. Patients were grouped by RN or PN and baseline characteristics were compared. Renal function was estimated by the Modification in Diet and Renal Disease (MDRD) formula. Multivariate linear regression was used to identify independent predictors of renal function. RESULTS 120 patients were treated with PN and 224 with RN. Mean age was 60.9 yr for PN and 62.6 yr for RN. Mean tumor size was 2.9cm for the PN group and 6.2cm for the RN group. Multivariate analysis identified radical nephrectomy, pre-operative GFR and Diabetes Mellitus (DM) as independent predictors of 1 year post-operative renal function. Patients undergoing RN had a mean decrease in GFR of 20.7 mL/min/1.73 m2 (95%CI 18.1- 23.3) compared to those undergoing PN. For each unit increase in pre-operative GFR, post-operative GFR increased by 0.66 mL/min/1.73 m2 (95%CI 0.60 -0.71). DM impacted a post-operative GFR decline by 3.6 mL/min/1.73 m2 (95% CI 0.7 – 6.6). CONCLUSIONS Pre-op GFR, type of surgery and DM were independent predictors of post-operative renal function. While our findings support nephron-sparing surgery for patients with chronic kidney disease, the value of nephron-sparing approaches in diabetic patients may be even greater. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e391 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Adiel E. Mamut More articles by this author Neal E. Rowe More articles by this author Philippe D. Violette More articles by this author Fulan Cui More articles by this author Patrick P.W. Luke More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...