Mp42-11 Excessive Risks for Developing Renal Failure After Cytoreductive Nephrectomy in the Metastatic Setting
Year: 2018
Type: article
Abstract: You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV1 Apr 2018MP42-11 EXCESSIVE RISKS FOR DEVELOPING RENAL FAILURE AFTER CYTOREDUCTIVE NEPHRECTOMY IN THE METASTATIC SETTING Christopher Martin, Erik Mayer, Robert Uzzo, Brian Lane, Alexander Kutikov, Marc Smaldone, Jason Gee, Larry Karsh, Thomas Gardner, Viraj Master, Jeffrey Holzbeierlein, and William Lowrance Christopher MartinChristopher Martin More articles by this author , Erik MayerErik Mayer More articles by this author , Robert UzzoRobert Uzzo More articles by this author , Brian LaneBrian Lane More articles by this author , Alexander KutikovAlexander Kutikov More articles by this author , Marc SmaldoneMarc Smaldone More articles by this author , Jason GeeJason Gee More articles by this author , Larry KarshLarry Karsh More articles by this author , Thomas GardnerThomas Gardner More articles by this author , Viraj MasterViraj Master More articles by this author , Jeffrey HolzbeierleinJeffrey Holzbeierlein More articles by this author , and William LowranceWilliam Lowrance More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1318AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Though radical cytoreductive nephrectomy has been shown to improve overall survival in patients with metastatic renal cell carcinoma, the impact this treatment has on renal function has not been adequately assessed. Radical nephrectomy in patients with localized cancer has been associated with risk of chronic kidney disease development. Using patients enrolled in ADAPT trial that received cytoreductive nephrectomy in the metastatic setting, we intend to study the effect of this procedure on overall renal function in patients without kidney disease. METHODS Patients were identified based on screening for the ADAPT trial undertaken from 2012-2015. 1148 patients were screened prior to the trial with 450 patients being enrolled. Patients included in our study were those included in the trial that had an estimated glomerular filtration rate of 60 or above. Univariate logistic regression analysis was used to evaluate the impact of patient and disease specific factors on post-operative renal function. RESULTS Our cohort included 371 patients. 169 patients (45.5%) developed chronic kidney disease stage 3 or worse (<60ml/min/1.73 m2) with short-term follow up. Patient specific factors associated with post-operative glomerular filtration rate <60ml/min/1.73 m2 were: age (p=<0.001), hypertension (p=0.005), Charleson Comorbidity Index score (p=<0.001), and prior history of nephrolithiasis (p=0.021). The only disease specific factor associated with post-operative glomerular filtration rate <60ml/min/1.73 m2 was the presence of liver metastasis (p=0.004). CONCLUSIONS Surprisingly our findings indicate that nearly half of patients with metastatic renal cell carcinoma develop new CKD shortly after cytoreductive nephrectomy. Older patients and those with a history of hypertension and a higher comorbidity index appear to be at an increased risk of post-operative CKD. This has important implications as renal replacement therapy could be a competing factor for morbidity and mortality with some patients treated for metastatic renal cell cancer. Extended follow-up is needed to better understand the long-term impact of these findings. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e540 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Christopher Martin More articles by this author Erik Mayer More articles by this author Robert Uzzo More articles by this author Brian Lane More articles by this author Alexander Kutikov More articles by this author Marc Smaldone More articles by this author Jason Gee More articles by this author Larry Karsh More articles by this author Thomas Gardner More articles by this author Viraj Master More articles by this author Jeffrey Holzbeierlein More articles by this author William Lowrance More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Authors: Christopher Martin, Erik Mayer, Robert Uzzo, Brian Lane, Alexander Kutikov, Marc Smaldone, Jason Gee, Larry Karsh, Thomas Gardner, Viraj Master, Jeffrey Holzbeierlein, William Lowrance
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2796345098