Non-neoplastic parenchymal changes in kidney cancer and post-partial nephrectomy recovery of renal function Journal Article

Authors: Bazzi, W. M.; Chen, L. Y.; Cordon, B. H.; Mashni, J.; Sjoberg, D. D.; Bernstein, M.; Russo, P.
Article Title: Non-neoplastic parenchymal changes in kidney cancer and post-partial nephrectomy recovery of renal function
Abstract: Objective: To explore the association of non-neoplastic parenchymal changes (nNPC) with patients’ health and renal function recovery after partial nephrectomy (PN). Materials and methods: This retrospective review identified 800 pT1a patients who underwent PN at Memorial Sloan Kettering Cancer Center from 2007 to 2012. Pathology reports were reviewed for nNPC graded as mild or severe: vascular sclerosis (VS), glomerulosclerosis (GS), and fibrosis/scarring. Correlations between nNPC and known preoperative predictors of renal function [age, sex, African-American race, estimated glomerular filtration rate (eGFR), American Society of Anesthesiologists (ASA) score, body mass index, coronary artery disease, and hypertension (HTN)] were assessed using Spearman’s rank correlation (ρ). Multivariable linear regression, adjusted for the described known preoperative risk predictors, was performed to evaluate whether the parenchymal features were able to predict 6-month postoperative eGFR. Results: In this study, 46 % of tumors had benign surrounding parenchyma. We noted statistically significant yet weak associations of VS with age (ρ = 0.19; p < 0.001), ASA (ρ = 0.09; p < 0.001), preoperative eGFR (ρ = −0.14; p < 0.001), and HTN (ρ = 0.14; p < 0.001). GS also significantly correlated with HTN, but the correlation was again small (ρ = 0.12; p < 0.001). After adjusting for known risk predictors, only GS was a significant predictor of 6-month postoperative eGFR. When compared with no GS, mild and severe GS were negatively associated with a decrease of 4.9 and 10.8 mL/min/1.73 m2 in 6-month postoperative eGFR, respectively. Conclusions: Presence of VS and GS correlated with patients’ baseline health, and presence of GS predicted postoperative renal function recovery. © 2015, Springer Science+Business Media Dordrecht.
Keywords: adult; aged; major clinical study; hypertension; retrospective study; kidney neoplasms; age; body mass; partial nephrectomy; scoring system; glomerulus filtration rate; sex difference; kidney cancer; coronary artery disease; african american; kidney parenchyma; renal insufficiency; arteriosclerosis; kidney diseases; kidney fibrosis; glomerulosclerosis; human; male; female; article; american society of anesthesiologists score; kidney scar
Journal Title: International Urology and Nephrology
Volume: 47
Issue: 9
ISSN: 0301-1623
Publisher: Springer  
Date Published: 2015-09-01
Start Page: 1499
End Page: 1502
Language: English
DOI: 10.1007/s11255-015-1066-1
PROVIDER: scopus
PUBMED: 26265107
PMCID: PMC5002226
Notes: Export Date: 2 October 2015 -- Source: Scopus
Citation Impact
MSK Authors
  1. Paul Russo
    505 Russo
  2. Daniel D. Sjoberg
    171 Sjoberg
  3. Wassim Mousa Bazzi
    14 Bazzi
  4. Billy Hamilton Cordon
    3 Cordon
  5. Ling Yun Chen
    19 Chen
  6. Joseph Wadie Mashni
    10 Mashni