Mp72-15 Robotic Partial Nephrectomy in Patients With Chronic Kidney Disease: Objective Measurement of Short and Long Term Renal Functional Outcomes
Year: 2017
Type: article
Study design: Observational Study
Abstract: METHODS: This multicenter study included 894 patients who had undergone RN between 1994 and 2014.Patients with bilateral renal tumors, metastases, preoperative ESRD, and follow-up <1 year were excluded.The primary endpoint was a >30% eGFR decrease from the postoperative baseline, which was defined as eGFR at 1 month after RN.We identified the preoperative risk factors for a >30% eGFR decrease using the Cox proportional hazard model.A riskstratification model incorporating independent risk factors was then generated.RESULTS: The median age, preoperative eGFR, and postoperative baseline eGFR of the 894 patients (593 men, 301 women) were 65 years, 70.5, and 45.1 ml/min/1.73m 2 , respectively.Of these, 235, 351, 126, and 131 patients had preoperative CKD defined as eGFR <60 ml/min/1.73m 2 , hypertension (HT), diabetes mellitus, and cardiovascular disease, respectively.During the median follow-up of 48 months, a >30% eGFR decrease from the postoperative baseline was observed in 47 patients (5.3%).ESRD requiring dialysis developed in 10 of the 47 patients.Multivariate analysis revealed that preoperative CKD and HT were independent risk factors for a >30% eGFR decrease.Five-year >30% eGFR decrease-free survival rates were 98%, 94%, and 84% in patients with 0, 1, and 2 risk factors, respectively (p < 0.001, Figure ).Of the 10 patients who developed ESRD, 8 had both risk factors and the remaining 2 had 1 risk factor.CONCLUSIONS: Approximately 5% of patients undergoing RN experienced a >30% eGFR decrease from the postoperative baseline, and one-fifth of these patients eventually developed ESRD.Preoperative CKD and HT were the risk factors for a >30% decline in eGFR.
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2604677693