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The Effect of Patient and Surgical Characteristics on Renal Function After Partial Nephrectomy
- Source :
- Clinical Genitourinary Cancer. 16:191-196
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Background The purpose of the study was to identify patient and disease characteristics that have an adverse effect on renal function after partial nephrectomy. Patients and Methods We conducted a retrospective review of 387 patients who underwent partial nephrectomy for renal tumors between 2006 and 2014. A line plot with a locally weighted scatterplot smoothing was generated to visually assess renal function over time. Univariable and multivariable longitudinal regression analyses incorporated a random intercept and slope to evaluate the association between patient and disease characteristics with renal function after surgery. Results Median age was 60 years and most patients were male (255 patients [65.9%]) and white (343 patients [88.6%]). In univariable analysis, advanced age at surgery, larger tumor size, male sex, longer ischemia time, history of smoking, and hypertension were significantly associated with lower preoperative estimated glomerular filtration rate (eGFR). In multivariable analysis, independent predictors of reduced renal function after surgery included advanced age, lower preoperative eGFR, and longer ischemia time. Length of time from surgery was strongly associated with improvement in renal function among all patients. Conclusion Independent predictors of postoperative decline in renal function include advanced age, lower preoperative eGFR, and longer ischemia time. A substantial number of subjects had recovery in renal function over time after surgery, which continued past the 12-month mark. These findings suggest that patients who undergo partial nephrectomy can experience long-term improvement in renal function. This improvement is most pronounced among younger patients with higher preoperative eGFR.
- Subjects :
- Adult
Male
medicine.medical_specialty
Urology
medicine.medical_treatment
030232 urology & nephrology
Renal function
Kidney
Nephrectomy
Article
Young Adult
03 medical and health sciences
0302 clinical medicine
Renal cell carcinoma
Humans
Medicine
Adverse effect
Carcinoma, Renal Cell
Aged
Retrospective Studies
Aged, 80 and over
Retrospective review
Tumor size
business.industry
Recovery of Function
Middle Aged
medicine.disease
Kidney Neoplasms
Tumor Burden
Oncology
030220 oncology & carcinogenesis
Regression Analysis
Female
Disease characteristics
business
Random intercept
Glomerular Filtration Rate
Subjects
Details
- ISSN :
- 15587673
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- Clinical Genitourinary Cancer
- Accession number :
- edsair.doi.dedup.....06eff3bf537571e7c7be947050e52813