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Postoperative elevation in creatine kinase and its impact on renal function in patients undergoing complex partial nephrectomy

Authors :
Andrew J. Mannes
W. Marston Linehan
Hong Truong
Ning Miao
Abhinav Sidana
Johanna Shih
M. Minhaj Siddiqui
Adam R. Metwalli
Gennady Bratslavsky
Annerleim Walton-Diaz
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.

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