Renal function recovery after radical nephroureterectomy for upper tract urothelial carcinoma Journal Article

Authors: Lee, B. H.; Zabor, E. C.; Tennenbaum, D.; Furberg, H.; Benfante, N.; Coleman, J. A.; Jaimes, E. A.; Russo, P.
Article Title: Renal function recovery after radical nephroureterectomy for upper tract urothelial carcinoma
Abstract: Purpose: To understand the longitudinal renal function trends in patients undergoing radical nephroureterectomy (RNU) and identify clinicopathologic characteristics associated with estimated glomerular filtration rate (eGFR) recovery. Methods: 147 patients were available for analysis. Longitudinal eGFR trends were assessed by plotting each patient’s eGFR measurements over time. The patient population was dichotomized using eGFR < 60 ml/min/1.73 m2 versus ≥ 60 ml/min/1.73 m2. Cumulative incidence and competing risk regression analysis were used to estimate recovery of postoperative eGFR to the preoperative level and identify clinicopathologic characteristics associated with eGFR recovery. Results: Median age was 68.7 years and median preoperative eGFR was 55.9 ml/min/1.73 m2. 63.6% were male and 95.8% were white. The cumulative incidence of eGFR recovery was significantly higher in patients with baseline eGFR < 60 ml/min/1.73 m2 compared to those with baseline eGFR ≥ 60 ml/min/1.73 m2 (p = 0.01), with recovery rates at 2 years of 56.6% vs. 27.7%, respectively. Multivariable analysis revealed that preoperative hydronephrosis (HR 1.80) and preoperative eGFR < 60 ml/min/1.73 m2 (HR 1.87) were associated with increased chance of eGFR recovery. Conclusion: Over half of patients with preoperative eGFR < 60 ml/min/1.73 m2 achieved eGFR recovery within the first 3 years after RNU, and hydronephrosis was a significant predictor of recovery. These findings should be considered when counseling patients regarding chronic kidney disease progression after RNU and timing of perioperative chemotherapy for high risk tumors. © 2017, Springer-Verlag GmbH Germany, part of Springer Nature.
Keywords: upper tract urothelial carcinoma; hydronephrosis; radical nephroureterectomy; renal function recovery
Journal Title: World Journal of Urology
Volume: 36
Issue: 2
ISSN: 0724-4983
Publisher: Springer  
Date Published: 2018-02-01
Start Page: 257
End Page: 263
Language: English
DOI: 10.1007/s00345-017-2139-9
PROVIDER: scopus
PUBMED: 29209771
PMCID: PMC6002847
Notes: Article -- Export Date: 1 March 2018 -- Source: Scopus
Citation Impact
MSK Authors
  1. Jonathan Coleman
    281 Coleman
  2. Paul Russo
    548 Russo
  3. Emily Craig Zabor
    171 Zabor
  4. Edgar Alberto Jaimes
    56 Jaimes
  5. Byron Hing Lung Lee
    14 Lee
  6. Nicole E Benfante
    105 Benfante