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. 2017 Jan-Feb;43(1):80-86.
doi: 10.1590/S1677-5538.IBJU.2015.0423.

The percentage of resected and ischemic volume determined by a geometric model is a significant predictor of renal functional change after partial nephrectomy

Wei-Hsuan Huang  1 , Chao-Hsiang Chang  1   2 , Chi-Ping Huang  1 , Hsi-Chin Wu  3 , Po-Fan Hsieh I  1
Affiliations

The percentage of resected and ischemic volume determined by a geometric model is a significant predictor of renal functional change after partial nephrectomy

Wei-Hsuan Huang et al. Int Braz J Urol. 2017 Jan-Feb.

Abstract

Purpose: The percentage of parenchyma preserved plays a predominant role in predicting renal function after partial nephrectomy (PN). Currently there is no standard method to estimate preserved renal parenchyma. In this study we propose a formula of the percentage of resected and ischemic volume (PRAIV) determined by a geometric model and evaluate the relationships between renal functional change and PRAIV as well as other clinical parameters.

Materials and methods: We identified 71 patients who underwent open PN between January 2004 and April 2014. Assuming the kidney to be an ellipsoid with bilaterally equal volume and tumor to be a sphere, we calculated PRAIV by integral calculus. Nadir estimated glomerular filtration rate (eGFR) between postoperative 3 and 12 months were recorded. The correlation between percent eGFR reduction, PRAIV, and other clinical parameters were examined.

Results: On univariate analysis, age (p=0.03), depth of tumor invasion (p=0.004), C index (p=0.003), RAIV (p=0.04), and PRAIV (p<0.001) were correlated with percent reduction of eGFR. However, only age (p=0.007) and PRAIV (p<0.001) were significantly correlated with percent reduction of eGFR on multivariate analysis. Depicting these values along the regression line, we found R2 was 0.194 and 0.073 for PRAIV and age, respectively.

Conclusions: PRAIV determined by a geometric model is a significant predictor of renal functional change after PN. Using PRAIV, we can estimate percent eGFR reduction preoperatively for better patient consultation and surgical planning.

Keywords: Delayed Graft Function; Kidney Neoplasms; Nephrectomy.

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Conflict of interest statement

CONFLICT OF INTEREST

None declared.

Figures

Figure 1
Figure 1. Illustration of geometric renal tumor model and calculation process of RAIV and PRAIV.
Figure 2
Figure 2. Correlation plots of percent eGFR reduction with PRAIV and age. A, percent eGFR reduction vs. PRAIV, y=1.512 + 2.752x, R2=0.194. B, percent eGFR reduction vs age, y=-4.958 + 0.324x, R2=0.073.
See this image and copyright information in PMC

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