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Predictive factors ...
Predictive factors of chronic kidney disease stage V after partial nephrectomy in a solitary kidney : a multi-institutional study
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Verhoest, G (författare)
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Patard, Jj (författare)
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Oger, E (författare)
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visa fler...
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Rioux-Leclercq, N (författare)
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Peyronnet, Benoit (författare)
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Bessède, T (författare)
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Laguna, P (författare)
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Barwari, K (författare)
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Rigaud, J (författare)
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Roupret, M (författare)
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Coffin, G (författare)
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Bernhard, Jc (författare)
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Long, Ja (författare)
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Zisman, A (författare)
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Berger, J (författare)
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Paparel, P (författare)
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Maurin, C (författare)
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Lechevallier, E (författare)
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Bertini, R (författare)
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Ouzaid, I (författare)
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Salomon, L (författare)
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Bex, A (författare)
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Farfara, R (författare)
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- Ljungberg, Börje (författare)
- Umeå universitet,Urologi och andrologi,Njurcancer
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Rodriguez, A R (författare)
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Bensalah, K (författare)
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(creator_code:org_t)
- Elsevier, 2014
- 2014
- Engelska.
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Ingår i: Urologic Oncology. - : Elsevier. - 1078-1439 .- 1873-2496. ; 32:1, s. 28.e21-28.e26
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- OBJECTIVE: Partial Nephrectomy (PN) in a solitary kidney is at risk of chronic kidney disease (CKD) stage V and/or haemodialysis (HD). Our objective was to determine predictive factors of CKD stage V in this population. MATERIAL & METHODS: Data from 300 patients were retrospectively collected from 16 tertiary centres. Clinical and operative parameters, tumor characteristics and renal function before surgery were analyzed. Patients with and without CKD stage V (defined as MDRD<15ml/min) were compared using χ2 and Student-t tests for qualitative and quantitative variables, respectively. Predictive factors of CKD stage V were evaluated with a multivariable analysis using a Cox regression model. RESULTS: Median age and BMI were 63 years old and 26kg/m², respectively. Most of the patients (65%) were male with an anatomic solitary kidney (88.3%). Median tumor size was 4cm and 98% were malignant tumors. Median operative time, blood loss and clamping time were 180min, 350ml and 20min respectively. Renal cooling was used in 19.3% and clamping of the pedicle was performed in 61.6%. Twenty five patients (8.5%) presented post operative CKD stage V at last follow-up and 18 underwent HD (6%) post-operatively because of acute renal insufficiency. There was no difference between CKD stage V and non CKD stage V patients concerning Charlson index, operative time (180min vs 179min, p= 0.39), blood loss (475ml vs 350ml, p= 0.51), use of renal cooling and type of clamping. Patients with CKD stage V were older (70 vs 63 years old, p= 0.005), had a lower baseline renal function (clearance MDRD 41 vs. 62ml/min, p<0.0001) and an increased tumor size (p= 0.02). Complications occurred in 91 patients (30%) with 16% of minor (Clavien 1-2) and 14% of major (Clavien>2) complications, respectively. In multivariable analysis, baseline MDRD, BMI, and the occurrence of a minor complication were independent predictive factors of post operative CKD stage V. CONCLUSION: PN in a solitary kidney is at risk of post-operative CKD stage V and HD. Pre-operative altered renal function and post operative complications are the main predictive factors of permanent CKD stage V.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Nyckelord
- Renal cell carcinoma
- Conservative surgery
- Kidney cancer
- Renal failure
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Verhoest, G
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Patard, Jj
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Oger, E
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Rioux-Leclercq, ...
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Peyronnet, Benoi ...
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Bessède, T
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visa fler...
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Laguna, P
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Barwari, K
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Rigaud, J
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Roupret, M
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Coffin, G
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Bernhard, Jc
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Long, Ja
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Zisman, A
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Berger, J
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Paparel, P
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Maurin, C
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Lechevallier, E
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Bertini, R
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Ouzaid, I
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Salomon, L
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Bex, A
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Farfara, R
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Ljungberg, Börje
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Rodriguez, A R
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Bensalah, K
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visa färre...
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MEDICIN OCH HÄLS ...
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Urologic Oncolog ...
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Umeå universitet