Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 20;42(1):381.
doi: 10.1007/s00345-024-05042-w.

Preoperative proteinuria correlates with renal function after partial nephrectomy for renal cell carcinoma

Michele Nicolazzini  1 , Carlotta Palumbo  1 , Francesca Porté  1 , Gianmarco Bondonno  1 , Paolo De Angelis  1 , Maria Teresa Del Galdo  1 , Alessandro Volpe  2
Affiliations

Preoperative proteinuria correlates with renal function after partial nephrectomy for renal cell carcinoma

Michele Nicolazzini et al. World J Urol. .

Abstract

Purpose: Preoperative proteinuria is a prognostic factor of chronic kidney disease (CKD). We assessed the association between preoperative proteinuria and postoperative renal function after partial nephrectomy (PN).

Methods: We retrospectively reviewed our records of patients with a single malignant renal mass who underwent PN between 2000 and 2021. Patients with data on preoperative proteinuria were included. Baseline characteristics and eGFR differences over time between patients with and without proteinuria were evaluated. Univariate and multivariable logistic regression models (LRM) tested for presence of CKDIII or higher at 12-month and at last follow-up.

Results: Two hundred ninety-five patients were included. Twenty-two of them had preoperative proteinuria. No differences of age, smoking status, hypertension or diabetes, tumor size and use of ischemia were observed. Patients with proteinuria had a higher rate of CKD-III at baseline. At a median follow-up of 46.5 months (IQR 19-82), 117 patients developed de novo CKD-III, without differences in the two groups. No differences in decline in eGFR were observed. At univariate LRM, predictors of CKD-III at 12 months after PN were preoperative proteinuria (OR 3.2, 95%CI 1.4-7.8, p = 0.005), age and baseline eGFR, while predictors of CKD-III at last follow-up were age and baseline eGFR. At multivariable LRM, only baseline eGFR predicted CKD-III at 12-month and at last-follow-up.

Conclusions: Preoperative eGFR is the only independent predictor of long-term renal function after PN. Preoperative proteinuria correlates with renal function at 12 months. Proteinuria should be assessed before PN to identify patients at higher risk of renal functional deterioration in the 12 months following PN.

Keywords: Carcinoma, renal cell; Chronic kidney disease; Partial nephrectomy; Proteinuria; Renal function.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Mean (± SD) eGFR at each timepoint. Orange line represents patients with preoperative proteinuria, blue line represents patients without preoperative proteinuria. The two thin black lines are the results of linear regression model: y = 70.1 – 0.51 × for patients with preoperative proteinuria and y = 88 – 0.35 × for patients without preoperative proteinuria
See this image and copyright information in PMC

Comment in

References

    1. Palumbo C, Pecoraro A, Knipper S et al (2020) Contemporary age-adjusted incidence and mortality rates of renal cell carcinoma: analysis according to gender race stage grade and histology. Eur Urol Focus. 10.1016/j.euf.2020.05.003 - DOI - PubMed
    1. Ljungberg B, Albiges L, Bedke J et al (2023) Renal cell carcinoma EAU Guidelines. Edn. presented at the EAU Annual Congress Milan. ISBN 978–94–92671–19–6.
    1. Capitanio U, Larcher A, Terrone C, Antonelli A, Volpe A et al (2016) End-stage renal disease after renal surgery in patients with normal preoperative kidney function: balancing surgical strategy and individual disorders at baseline. Eur Urol. 10.1016/j.eururo.2016.03.023 - DOI - PubMed
    1. Kim SP, Thompson RH, Boorjian SA et al (2012) Comparative effectiveness for survival and renal function of partial and radical nephrectomy for localized renal tumors: a systematic review and meta-analysis. J Urol. 10.1016/j.juro.2012.03.006 - DOI - PubMed
    1. Pecoraro A, Campi R, Bertolo R et al (2023) Estimating postoperative renal function after surgery for nonmetastatic renal masses: a systematic review of available prediction models. Eur Urol Oncol. 10.1016/j.euo.2022.11.007 - DOI - PubMed