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 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 March 2018 -- Source: Scopus |
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