Study aim: To characterize the associated factors of postoperative renal global functional deterioration after partial nephrectomy (PN), comprehensive analyses were performed using multiple factors categorized as data from pre, intra and postoperative periods. Methods: Ninety-three patients underwent PN. Estimated glomerular filtration rate (eGFR) and computed tomography (CT) scans were examined pre- and 6 months postoperatively. Renal global functional deterioration after PN was assessed by postoperative percent of eGFR decline. Pre- and postoperative renal parenchymal volume (RPV) was measured by the Synapse Vincent volumetric analyzer which creates a reconstructed image from a CT scan. Additional factors that were analyzed included patient demographics, comorbidities, surgical factors and tumor pathology. All factors demonstrating statistical tendencies (P < 0.1) in univariate analyses were subjected to multivariate logistic regression analysis. Two groups were categorized according to the degree of eGFR decline. Groups A and B were categorized as less than 15% and greater than 15% declines, respectively. Results: The case distributions of hypertension (HTN) and male gender were significantly shifted in group B. Significant compensatory renal hypertrophy of the contralateral side occurred postoperatively. The percent increment of RPV in the contralateral side in group B was significantly lower than that in group A. In multivariate analysis, HTN was the sole independent associated factor in group B. Conclusions: Host factors, rather than surgical factors, may be associated with postoperative renal global functional deterioration in PN. Surgeons should consider medical problems in addition to surgical skills especially in HTN patients.
| Published in | Advances in Surgical Sciences (Volume 7, Issue 1) |
| DOI | 10.11648/j.ass.20190701.15 |
| Page(s) | 21-28 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2019. Published by Science Publishing Group |
Estimated Glomerular Filtration Rate, Partial Nephrectomy, Renal Function, Renal Volume
| [1] | Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010; 127: 2893-2917. |
| [2] | Li P, Znaor A, Holcatova I, Fabianova E, Mates D, Wozniak MB, Ferlay J, Scelo G. Regional geographic variations in kidney cancer incidence rates in European countries. Eur Urol. 2015; 67: 1134-1141. |
| [3] | Cote ML, Colt JS, Schwartz KL, Wacholder S, Ruterbusch JJ, Davis F, Purdue M, Graubard BI, Chow WH. Cigarette smoking and renal cell carcinoma risk among black and white Americans: effect modification by hypertension and obesity. Cancer Epidemiol Biomarkers Prev. 2012; 21: 770-779. |
| [4] | Roos FC, Brenner W, Jäger W, Albert C, Müller M, Thüroff JW, Hampel C. Perioperative morbidity and renal function in young and elderly patients undergoing elective nephron-sparing surgery or radical nephrectomy for renal tumours larger than 4 cm. BJU Int. 2011; 107: 554-561. |
| [5] | Lane BR, Fergany AF, Weight CJ, Campbell SC. Renal functional outcomes after partial nephrectomy with extended ischemic intervals are better than after radical nephrectomy. J Urol. 2010; 184: 1286-1290. |
| [6] | Ohno Y, Nakashima J, Ohori M, Hashimoto T, Iseki R, Hatano T, Tachibana M. Impact of tumor size on renal function and prediction of renal insufficiency after radical nephrectomy in patients with renal cell carcinoma. J Urol. 2011; 186: 1242-1246. |
| [7] | Campbell SC, Novick AC, Belldegrun A, Blute ML, Chow GK, Derweesh IH, Faraday MM, Kaouk JH, Leveillee RJ, Matin SF, Russo P, Uzzo RG; Practice Guidelines Committee of the American Urological Association (2009) Guideline for management of the clinical T1 renal mass. J Urol. 2009; 182: 1271-1279. |
| [8] | Uzzo RG, Novick AC. Nephron sparing surgery for renal tumors: indications, techniques and outcomes. J Urol. 2001; 166: 6-18. |
| [9] | Gill IS, Aron M, Gervais DA, Jewett MA. Clinical practice. Small renal mass. N Engl J Med. 2010; 362: 624-634. |
| [10] | Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, Yamagata K, Tomino Y, Yokoyama H, Hishida A; Collaborators developing the Japanese equation for estimated GFR (2009) Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009; 53: 982-992. |
| [11] | Kutikov A, Uzzo RG. The R. E. N. A. L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009; 182: 844-853. |
| [12] | Mir MC, Ercole C, Takagi T, Zhang Z, Velet L, Remer EM, Demirjian S, Campbell SC. Decline in renal function after partial nephrectomy: etiology and prevention. J Urol. 2015; 193: 1889-1898. |
| [13] | Thompson RH, Lane BR, Lohse CM, Leibovich BC, Fergany A, Frank I, Gill IS, Blute ML, Campbell SC. Every minute counts when the renal hilum is clamped during partial nephrectomy. Eur Urol. 2010; 58: 340-345. |
| [14] | Kim JH, Park YH, Kim YJ, Kang SH, Byun SS, Kwak C, Hong SH. Perioperative and long-term renal functional outcomes of robotic versus laparoscopic partial nephrectomy: a multicenter matched-pair comparison. World J Urol. 2015; 33: 1579-1584. |
| [15] | Muramaki M, Miyake H, Sakai I, Fujisawa M. Prognostic Factors Influencing Postoperative Development of Chronic Kidney Disease in Patients with Small Renal Tumors who Underwent Partial Nephrectomy. Curr Urol. 2013; 6: 129-135. |
| [16] | Jeon HG, Choo SH, Jeong BC, Seo SI, Jeon SS, Choi HY, Lee HM. Uric acid levels correlate with baseline renal function and high levels are a potent risk factor for postoperative chronic kidney disease in patients with renal cell carcinoma. J Urol. 2013; 189: 1249-1254. |
| [17] | Abouassaly R, Finelli A, Tomlinson GA, Urbach DR, Alibhai SM. How often are patients with diabetes or hypertension being treated with partial nephrectomy for renal cell carcinoma? A population-based analysis. BJU Int. 2011; 108: 1806-1812. |
| [18] | Earle KA, Ng L, White S, Zitouni K. Sex differences in vascular stiffness and relationship to the risk of renal functional decline in patients with type 2 diabetes. Diab Vasc Dis Res. 2017; 14: 304-309. |
| [19] | Van den Munckhof ICL, Holewijn S, de Graaf J, Rutten JHW. Sex differences in fat distribution influence the association between BMI and arterial stiffness. J Hypertens. 2017; 35: 1219-1225. |
| [20] | Takagi T, Mir MC, Sharma N, Remer EM, Li J, Demirjian S, Kaouk JH, Campbell SC. Compensatory hypertrophy after partial and radical nephrectomy in adults. J Urol. 2014; 192: 1612-1618. |
| [21] | Mibu H, Tanaka N, Hosokawa Y, Kumamoto H, Margami N, Hirao Y, Fujimoto K. Estimated functional renal parenchymal volume predicts the split renal function following renal surgery. World J Urol. 2015; 33: 1571-1577. |
| [22] | Isotani S, Shimoyama H, Yokota I, Noma Y, Kitamura K, China T, Saito K, Hisasue S, Ide H, Muto S, Yamaguchi R, Ukimura O, Gill IS, Horie S. Novel prediction model of renal function after nephrectomy from automated renal volumetry with preoperative multidetector computed tomography (MDCT). Clin Exp Nephrol. 2015; 19: 974-981. |
| [23] | Kim DK, Jang Y, Lee J, Hong H, Kim KH, Shin TY, Jung DC, Choi YD, Rha KH. Two-year analysis for predicting renal function and contralateral hypertrophy after robot-assisted partial nephrectomy: A three-dimensional segmentation technology study. Int J Urol. 2015; 22: 1105-1111. |
| [24] | Mir MC, Campbell RA, Sharma N, Remer EM, Simmons MN, Li J, Demirjian S, Kaouk J, Campbell SC (2013) Parenchymal volume preservation and ischemia during partial nephrectomy: functional and volumetric analysis. Urology. 2013; 82: 263-268. |
| [25] | Park BH, Jeong BC, Jeon SS, Seo SI, Lee HM, Choi HY, Jeon HG. Volumetric measurement of compensatory hypertrophy in the contralateral normal kidney by the tumor growth. World J Urol. 2016; 34: 63-68. |
| [26] | Lindblad P, Chow WH, Chan J, Bergström A, Wolk A, Gridley G, McLaughlin JK, Nyrén O, Adami HO. The role of diabetes mellitus in the aetiology of renal cell cancer. Diabetologia. 1999; 42: 107-112. |
| [27] | Shapiro JA, Williams MA, Weiss NS, Stergachis A, LaCroix AZ, Barlow WE. Hypertension, antihypertensive medication use, and risk of renal cell carcinoma. Am J Epidemiol. 1999; 149: 521-530. |
| [28] | Shapiro JA, Williams MA, Weiss NS. Body mass index and risk of renal cell carcinoma. Epidemiology. 1999; 10: 188-191. |
| [29] | Yuan JM, Castelao JE, Gago-Dominguez M, Yu MC, Ross RK. Tobacco use in relation to renal cell carcinoma. Cancer Epidemiol Biomarkers Prev. 1998; 7: 429-433. |
| [30] | Bijol V, Mendez GP, Hurwitz S, Rennke HG, Nosé V. Evaluation of the nonneoplastic pathology in tumor nephrectomy specimens: predicting the risk of progressive renal failure. Am J Surg Pathol. 2006; 30: 575-584. |
APA Style
Takehiro Sejima, Toshihiko Masago, Tetsuya Yumioka, Shuichi Morizane, Masashi Honda, et al. (2019). Comprehensive Analyses of Factors Associated with Postoperative Renal Global Function in Patients Treated by Partial Nephrectomy. Advances in Surgical Sciences, 7(1), 21-28. https://doi.org/10.11648/j.ass.20190701.15
ACS Style
Takehiro Sejima; Toshihiko Masago; Tetsuya Yumioka; Shuichi Morizane; Masashi Honda, et al. Comprehensive Analyses of Factors Associated with Postoperative Renal Global Function in Patients Treated by Partial Nephrectomy. Adv. Surg. Sci. 2019, 7(1), 21-28. doi: 10.11648/j.ass.20190701.15
AMA Style
Takehiro Sejima, Toshihiko Masago, Tetsuya Yumioka, Shuichi Morizane, Masashi Honda, et al. Comprehensive Analyses of Factors Associated with Postoperative Renal Global Function in Patients Treated by Partial Nephrectomy. Adv Surg Sci. 2019;7(1):21-28. doi: 10.11648/j.ass.20190701.15
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.ass.20190701.15,
author = {Takehiro Sejima and Toshihiko Masago and Tetsuya Yumioka and Shuichi Morizane and Masashi Honda and Atsushi Takenaka},
title = {Comprehensive Analyses of Factors Associated with Postoperative Renal Global Function in Patients Treated by Partial Nephrectomy},
journal = {Advances in Surgical Sciences},
volume = {7},
number = {1},
pages = {21-28},
doi = {10.11648/j.ass.20190701.15},
url = {https://doi.org/10.11648/j.ass.20190701.15},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20190701.15},
abstract = {Study aim: To characterize the associated factors of postoperative renal global functional deterioration after partial nephrectomy (PN), comprehensive analyses were performed using multiple factors categorized as data from pre, intra and postoperative periods. Methods: Ninety-three patients underwent PN. Estimated glomerular filtration rate (eGFR) and computed tomography (CT) scans were examined pre- and 6 months postoperatively. Renal global functional deterioration after PN was assessed by postoperative percent of eGFR decline. Pre- and postoperative renal parenchymal volume (RPV) was measured by the Synapse Vincent volumetric analyzer which creates a reconstructed image from a CT scan. Additional factors that were analyzed included patient demographics, comorbidities, surgical factors and tumor pathology. All factors demonstrating statistical tendencies (P Results: The case distributions of hypertension (HTN) and male gender were significantly shifted in group B. Significant compensatory renal hypertrophy of the contralateral side occurred postoperatively. The percent increment of RPV in the contralateral side in group B was significantly lower than that in group A. In multivariate analysis, HTN was the sole independent associated factor in group B. Conclusions: Host factors, rather than surgical factors, may be associated with postoperative renal global functional deterioration in PN. Surgeons should consider medical problems in addition to surgical skills especially in HTN patients.},
year = {2019}
}
TY - JOUR T1 - Comprehensive Analyses of Factors Associated with Postoperative Renal Global Function in Patients Treated by Partial Nephrectomy AU - Takehiro Sejima AU - Toshihiko Masago AU - Tetsuya Yumioka AU - Shuichi Morizane AU - Masashi Honda AU - Atsushi Takenaka Y1 - 2019/04/08 PY - 2019 N1 - https://doi.org/10.11648/j.ass.20190701.15 DO - 10.11648/j.ass.20190701.15 T2 - Advances in Surgical Sciences JF - Advances in Surgical Sciences JO - Advances in Surgical Sciences SP - 21 EP - 28 PB - Science Publishing Group SN - 2376-6182 UR - https://doi.org/10.11648/j.ass.20190701.15 AB - Study aim: To characterize the associated factors of postoperative renal global functional deterioration after partial nephrectomy (PN), comprehensive analyses were performed using multiple factors categorized as data from pre, intra and postoperative periods. Methods: Ninety-three patients underwent PN. Estimated glomerular filtration rate (eGFR) and computed tomography (CT) scans were examined pre- and 6 months postoperatively. Renal global functional deterioration after PN was assessed by postoperative percent of eGFR decline. Pre- and postoperative renal parenchymal volume (RPV) was measured by the Synapse Vincent volumetric analyzer which creates a reconstructed image from a CT scan. Additional factors that were analyzed included patient demographics, comorbidities, surgical factors and tumor pathology. All factors demonstrating statistical tendencies (P Results: The case distributions of hypertension (HTN) and male gender were significantly shifted in group B. Significant compensatory renal hypertrophy of the contralateral side occurred postoperatively. The percent increment of RPV in the contralateral side in group B was significantly lower than that in group A. In multivariate analysis, HTN was the sole independent associated factor in group B. Conclusions: Host factors, rather than surgical factors, may be associated with postoperative renal global functional deterioration in PN. Surgeons should consider medical problems in addition to surgical skills especially in HTN patients. VL - 7 IS - 1 ER -
Information
Email: