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. 2013 Jan;6(3):129-35.
doi: 10.1159/000343526. Epub 2012 Dec 21.

Prognostic Factors Influencing Postoperative Development of Chronic Kidney Disease in Patients with Small Renal Tumors who Underwent Partial Nephrectomy

Mototsugu Muramaki  1 , Hideaki Miyake  1 , Iori Sakai  1 , Masato Fujisawa  1
Affiliations

Prognostic Factors Influencing Postoperative Development of Chronic Kidney Disease in Patients with Small Renal Tumors who Underwent Partial Nephrectomy

Mototsugu Muramaki et al. Curr Urol. 2013 Jan.

Abstract

Background: The objective of this study was to determine factors associated with the postoperative development of chronic kidney disease (CKD) following partial nephrectomy.

Patients and methods: This study included 109 patients with normal renal function treated with partial nephrectomy for small renal tumors. Of these, 73 and 36 patients underwent open partial nephrectomy (OPN) and laparoscopic partial nephrectomy (LPN), respectively.

Results: Among several parameters, there was a significant difference only in the ischemia time between the OPN and LPN groups. During the median observation period of 53.4 months, CKD, defined as estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 m(2), developed in 29 (39.7%) and 14 (38.9%) patients in the OPN and LPN groups, respectively. Univariate analysis identified age at surgery, diabetes and preoperative eGFR as significant predictors of the postoperative development of CKD; however, only age at surgery and preoperative eGFR appeared to be independently related to CKD-free survival. In fact, there was a significant difference in the CKD-free survival between patients without any independent risk factor and those with at least one of these independent risk factors.

Conclusions: Careful management following partial nephrectomy is necessary for elderly patients and/or those with impaired renal function, even mild, before surgery.

Keywords: Chronic kidney disease; Estimated glomerular filtration rate; Partial nephrectomy; Small renal tumor.

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Figures

Fig. 1
Fig. 1
CKD-free survival in patients with small renal tumors who underwent partial nephrectomy.
Fig. 2
Fig. 2
Comparison of CKD-free survival in patients with small renal tumors who underwent partial nephrectomy according to the number of independent risk factors for postoperative development of CKD, including ≤ 60 years at surgery and eGFR < 70 ml/min/1.73 m2.
See this image and copyright information in PMC

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