Predictive factors for the development of chronic renal insufficiency after renal surgery: a multicenter study

Springer Science and Business Media LLC - Tập 46 - Trang 681-686 - 2013
Yong Sun Choi1, Yong Hyun Park2, Yong-June Kim3, Seok Ho Kang4, Seok-Soo Byun5, Sung-Hoo Hong1,6
1Department of Urology, College of Medicine, the Catholic University of Korea, Seoul, Korea
2Department of Urology, Seoul National University College of Medicine, Seoul, Korea
3Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea
4Department of Urology, Korea University School of Medicine, Seoul, Korea
5Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
6Seoul St. Mary’s Hospital, Seoul, Korea

Tóm tắt

To evaluate which factors affecting changes in postoperative renal function after conducting radical nephrectomy or partial nephrectomy. Data on patients who underwent operations for renal cell carcinoma between 2000 and 2010 at multiple institutions were collected. Patient characteristics including preoperative estimated glomerular filtration rate (EGFR) were investigated, and types of surgery and postoperative results were evaluated. Renal insufficiency was defined as an EGFR <60 ml/min/1.73 m2. Cox proportional hazard regression analysis was used to investigate which factors were associated with chronic renal insufficiency after surgery. A total of 2,454 patients were included for evaluation; 1,502 patients underwent radical nephrectomy, whereas 952 patients underwent partial nephrectomy. The mean follow-up period was 44.48 ± 27.04 months (range, 12–120 months). Factors affecting EGFR were age, diabetes, hypertension, surgical procedure, and preoperative creatinine level (p < 0.001). Factors affecting postoperative renal insufficiency were age, surgical procedure, serum creatinine level, and EGFR. The risk for developing post-nephrectomy renal insufficiency in patients who underwent radical nephrectomy was higher than those who underwent partial nephrectomy. Factors affecting post-nephrectomy renal insufficiency were age, preoperative serum creatinine level, and preoperative EGFR. In addition to radical nephrectomy, patient >58 years with a preoperative serum creatinine >1.03 mg/ml, and EGFR <73 ml/min/1.73 m2 had a higher probability of developing post-nephrectomy chronic renal insufficiency.

Tài liệu tham khảo

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Springer Science and Business Media LLC

Tập 46

681-686

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