metricas
covid
Buscar en
Actas Urológicas Españolas (English Edition)
Toda la web
Inicio Actas Urológicas Españolas (English Edition) Evolution of renal function in patients with cT1 renal tumors after laparoscopic...
Journal Information
Vol. 46. Issue 2.
Pages 63-69 (March 2022)
Share
Share
Download PDF
More article options
Visits
4
Vol. 46. Issue 2.
Pages 63-69 (March 2022)
Original article
Evolution of renal function in patients with cT1 renal tumors after laparoscopic partial and radical nephrectomy. Predictive factors for renal function impairment
Evolución de la función renal en pacientes con cáncer renal cT1 después de nefrectomía parcial y radical laparoscópica. Factores predictores de deterioro de función renal
Visits
4
A. Luis Cardoa,
Corresponding author
adrian.luis@salud.madrid.org

Corresponding author.
, F. Herranz Amoa, M. Rodríguez Caberoa, J. Hernández Cavieresa, D. Subirá Ríosa, M. Moralejo Gáratea, J. Aragón Chamizoa, G. Barbas Bernardosb, D. Ramirez Martínc, C. Hernández Fernándeza
a Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
b Servicio de Urología, Clínica Universidad de Navarra, Madrid, Spain
c Servicio de Urología, Hospital Universitario Infanta Elena, Madrid, Spain
This item has received
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Tables (3)
Table 1. Comparison of clinical variables between RN and PN.
Table 2. Predictive factors of GFR deterioration at discharge. Multivariate analysis (logistic regression).
Table 3. Predictors of GFR deterioration at the end of follow-up. Multivariate analysis (Cox regression).
Show moreShow less
Abstract
Introduction and objectives

To analyze the evolution of kidney function after laparoscopic partial nephrectomy (PN) and radical nephrectomy (RN) and to identify predictive factors for renal function impairment.

Materials and method

Retrospective study of patients with two kidneys, glomerular filtration rate (GFR) > 60 mL/min/1.73 m2 and single renal tumor cT1, treated in our center between 2005 and 2018.

Results

A total of 372 patients met the inclusion criteria for the study; 156 (41.9%) were treated with RN and 216 (58.1%) with PN. There was a difference of 26.75 mL/min/1.73 m2 in GFR between RN and PN at discharge. Age >60 years, postoperative complications (OR 2.97, p = 0.005) and RN (OR 10.03, p = 0.0001) were predictors of GFR <60 mL/min/1.73 m2 at discharge. Only RN (OR 7.69, p = 0.0001) behaved as an independent prognostic factor for GFR <45 mL/min/1.73 m2 at discharge. The median follow-up of the series was 57 (IQR 28–100) months. At the end of the follow-up period, nine (6%) patients treated with RN developed severe chronic kidney disease (CKD) and three (2%) developed end stage renal disease (ESRD). Age >70 years, diabetes mellitus (DM) (HR 2.12, p = 0.001), arterial hypertension (AHT) (HR 1.73, p = 0.01) and RN (HR 2.88, p = 0.0001) behaved as independent predictors of GFR <60 mL/min/1.73 m2. The independent predictors for GFR <45 mL/min/1.73 m2 were age >70 years, DM (HR 1.99 CI 95% 1.04–3.83, p = 0.04) and RN (HR 5.88 CI 95% 2.57–13.45, p = 0.0001).

Conclusions

RN is a short- and long-term risk factor for CKD although with a low probability of severe CKD or ESRD in patients with preoperative GFR >60 mL/min/1.73 m2. Age, DM and AHT contribute to worsening renal function during follow-up.

Keywords:
Partial nephrectomy
Radical nephrectomy
Renal function
Chronic kidney disease
Renal cancer
Resumen
Introducción y objetivos

Analizar la evolución de la función renal tras nefrectomía parcial (NP) y radical (NR) laparoscópica e identificar factores predictores de deterioro de función renal.

Material y método

Estudio retrospectivo de pacientes birrenos con filtrado glomerular (FG) > 60 mL/min/1,73 m2 y tumor renal único cT1 tratados en nuestro centro entre los años 2005 y 2018.

Resultados

372 pacientes cumplieron los criterios de inclusión para el estudio. 156 (41,9%) fueron tratados mediante NR y 216 (58,1%) mediante NP. Al alta hubo una diferencia de 26,75 mL/min/1,73 m2 de FG entre NR y NP. La edad > 60 años, las complicaciones postoperatorias (OR 2,97, p = 0,005) y NR (OR 10,03, p = 0,0001) fueron factores predictores de FG < 60 mL/min/1,73 m2 al alta. Únicamente la NR (OR 7,69, p = 0,0001) se comportó como factor pronóstico independiente de FG < 45 mL/min/1,73 m2 al alta. La mediana de seguimiento de la serie fue de 57 (IQR 28 a 100) meses. Al final del seguimiento, nueve (6%) pacientes tratados con NR desarrollaron enfermedad renal crónica (ERC) grave y tres (2%) insuficiencia renal terminal (IRT). Edad > 70 años, diabetes mellitus (DM) (HR 2,12, p = 0,001), hipertensión arterial (HTA) (HR 1,73, p = 0,01) y NR (HR 2,88, p = 0,0001) se comportaron como factores predictores independientes de FG < 60 mL/min/1,73 m2. Para un FG < 45 mL/min/1,73 m2 fueron edad > 70 años, DM (HR 1,99 IC 95% 1,04 a 3,83, p = 0,04) y NR (HR 5,88 IC 95% 2,57 a 13,45, p = 0,0001).

Conclusiones

La NR es un factor de riesgo a corto y largo plazo de ERC, aunque con baja probabilidad de ERC grave o IRT en pacientes con FG > 60 mL/min/1,73 m2 preoperatoria. Edad, DM e HTA contribuyen al empeoramiento de la función renal durante el seguimiento.

Palabras clave:
Nefrectomía parcial
Nefrectomía radical
Función renal
Enfermedad renal crónica
Cáncer renal

Article

These are the options to access the full texts of the publication Actas Urológicas Españolas (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Actas Urológicas Españolas (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos