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Postoperative elevation in creatine kinase and its impact on renal function in patients undergoing complex partial nephrectomy
- Source :
- International Urology and Nephrology. 48:1047-1053
- Publication Year :
- 2016
- Publisher :
- Springer Science and Business Media LLC, 2016.
-
Abstract
- To identify the risk factors associated with development of postoperative elevation of creatine kinase (CK) and study its effect on renal function in patients who underwent complex multifocal partial nephrectomy (PN).Patients who underwent PN at National Cancer Institute between January 2007 and December 2012 were included in the study. Elevated serum CK was defined as2000 U/L. Kidney function was assessed using serum creatinine and estimated glomerular filtration rate (eGFR). Changes were reported as percent change from preoperative values and compared using the Wilcoxon test. Regression analysis was performed to identify the predictors of elevation in CK and decline in eGFR.From 407 total cases, 207 had adequate CK data for analysis. Median number of tumors removed was 3 (1-70). Median peak CK was 1458 (82-36,788). Forty-two percent developed CK elevation2000 U/L. Factors associated with postoperative elevation of CK 2000 were young age (p = 0.009), high BMI (p = 0.003) and operating room time (p 0.001). Although CK 2000 was associated with significantly greater decline in eGFR (37.4 vs. 20.3 %, p 0.001) in immediate postoperative period, this change largely resolved to a much less clinically relevant (9.2 vs 3.3 %, p = 0.040) change after 3 months. On multivariate analysis, postoperative elevation in CK was not found to be an independent factor determining renal function at 3 months.In our cohort, a significant proportion of patients developed CK elevations2000 U/L. While patients with elevated CK had more decline in eGFR in immediate postoperative period, postoperative elevations of CK did not appear to impact overall long-term renal function in patients undergoing PN.
- Subjects :
- Male
Nephrology
Databases, Factual
medicine.medical_treatment
030232 urology & nephrology
Kidney Function Tests
Nephrectomy
chemistry.chemical_compound
Postoperative Complications
0302 clinical medicine
030212 general & internal medicine
Creatine Kinase
biology
Middle Aged
Prognosis
Kidney Neoplasms
Treatment Outcome
Creatinine
Female
Rhabdomyolysis
Glomerular Filtration Rate
Adult
medicine.medical_specialty
Urology
Renal function
Sensitivity and Specificity
Article
03 medical and health sciences
Internal medicine
medicine
Humans
Survival analysis
Aged
Retrospective Studies
Postoperative Care
Analysis of Variance
business.industry
Retrospective cohort study
medicine.disease
Survival Analysis
Surgery
Logistic Models
chemistry
Multivariate Analysis
Linear Models
biology.protein
Creatine kinase
business
Biomarkers
Subjects
Details
- ISSN :
- 15732584 and 03011623
- Volume :
- 48
- Database :
- OpenAIRE
- Journal :
- International Urology and Nephrology
- Accession number :
- edsair.doi.dedup.....130ee7effa7133497b258df94b1db891
- Full Text :
- https://doi.org/10.1007/s11255-016-1284-1