Partial nephrectomy for renal tumors in solitary kidneys: Postoperative renal function dynamics Journal Article

Authors: Ghoneim, T. P.; Sjoberg, D. D.; Lowrance, W.; Shariat, S. F.; Savage, C.; Bernstein, M.; Russo, P.
Article Title: Partial nephrectomy for renal tumors in solitary kidneys: Postoperative renal function dynamics
Abstract: Objective: To describe renal functional outcomes after partial nephrectomy (PN) for a tumor in a solitary kidney using the estimated glomerular filtration rate eGFR (MDRD equation). Patients and methods: A retrospective review of 103 cases of PN in a solitary kidney at Memorial Sloan-Kettering Cancer Center from December 1989 to July 2010 was conducted. The postoperative eGFR measurements were broken into three timeframes: 1–10 days after PN, 10 days–8 weeks after PN, and 4–12 months after PN. Several factors were analyzed for their impact on postoperative eGFR on univariate and multivariable analyses. To illustrate the change in eGFR after surgery over time, a univariate generalized estimating equation (GEE) model was constructed. Results: Median preoperative eGFR was 47 ml/min/1.72 m2 (IQR 39, 58). Higher preoperative eGFR, younger age at the time of PN, less estimated blood loss during PN, increased time between PN and previous radical nephrectomy, and decreased arterial clamp (ischemia) time were all significantly associated with increased postoperative eGFR in the early postoperative period on multivariable analysis. Younger age and higher preoperative eGFR were the only variables significantly associated with increased postoperative eGFR at all three time points. From the GEE model, postoperative eGFR continues to rise after PN until it reaches a plateau approximately 1 month after PN without attaining preoperative levels. Conclusion: PN for tumors in a solitary kidney is feasible and safe. In our model, non-modifiable factors predict the long-term postoperative eGFR: Young patients with healthy kidneys have superior renal functional results. © 2015, Springer-Verlag Berlin Heidelberg.
Keywords: outcome assessment; postoperative complications; partial nephrectomy; carcinoma; renal cell; renal function
Journal Title: World Journal of Urology
Volume: 33
Issue: 12
ISSN: 0724-4983
Publisher: Springer  
Date Published: 2015-12-01
Start Page: 2023
End Page: 2029
Language: English
DOI: 10.1007/s00345-015-1581-9
PROVIDER: scopus
PUBMED: 25966661
PMCID: PMC4983767
Notes: Export Date: 2 December 2015 -- Source: Scopus
Citation Impact
MSK Authors
  1. Caroline Savage
    80 Savage
  2. Paul Russo
    543 Russo
  3. Shahrokh Shariat
    68 Shariat
  4. Daniel D. Sjoberg
    201 Sjoberg
  5. Tarek Ghoneim
    12 Ghoneim