Category: Clinical Oncology: Outcomes & Complications

MP23-3 - Factors Associated with Substantial Decline in Renal Function following Partial Nephrectomy

Sat, Sep 22
2:00 PM - 4:00 PM

Introduction & Objective : To evaluate the factors that predict significant decline in renal function following partial nephrectomy (PN) at a minimum of 6 months follow-up.


Methods : Between May 2013 and November 2017, 323 patients underwent PN at Hackensack University Medical Center (HUMC). These patients were entered in an IRB – approved prospective/retrospective database. Inclusion criteria for this study included adherence to at least 6 months postoperative follow-up with a GFR measurement at that time. Univariate analysis was performed utilizing non-modifiable (age, sex, race, comorbid conditions, medications, pre-operative GFR, hematuria, proteinuria, tumor volume, tumor grade) and modifiable factors (operative time, ischemia time and type, mannitol administration, urine output, IV fluids, estimated blood loss) that are associated with the following outcomes at 6 months: decrease in GFR of over 25% (ΔGFR), downgrade in chronic kidney disease (CKD) stage (ΔStage) (Table 1).


Results : Eighty-one patients met inclusion criteria. We found a significant difference (p = 0.003) in age between patients who experienced ΔGFR and those who did not (69.0 vs. 58.7 years, respectively). There was a statistically significant difference (p = 0.046) in the percentage of patients with diabetes between patients who experienced ΔGFR than those who did not (40% vs 18%, respectively). For all other factors, there was no statistically significant difference between patients who experienced ΔGFR compared to those who did not. A summary of variables found to be significant predictors of ΔStage can be found in Table 2. We also found that patients with GFR <60ml/min were more likely to experience ΔStage than those that did not (OR: 5.8, p = 0.004).


Conclusions : We identified a number of factors that predict significant changes in renal function following PN. With an expanding prospective database, future studies should include multivariable analysis in the hopes of creating a predictive model.

Benjamin Press

Medical Student
Rutgers - New Jersey Medical School
Newark, New Jersey

Jessica A. Connor

Medical student
Rutgers - New Jersey Medical School
Ridgewood, New Jersey

Saikrishnaraya Doppalapudi

Medical Student
Rutgers - New Jersey Medical School
Plainsboro, New Jersey

Thaiphi Luu

Medical Student
Rutgers - New Jersey Medical School
Cedar Brook, New Jersey

Thaiphi Luu, 4th year medical student, Rutgers New Jersey Medical School

Radhika Ragam

Medical Student
Rutgers - New Jersey Medical School
Flemington, New Jersey

Tenzin Lama-Tamang

Hackensack University Medical Center
Hackensack, New Jersey

Helaine Koster

Hackensack University Medical Center
Hackensack, New Jersey

John Stites

Fellow, Endourology, Laparoscopy, Robotic Surgery
Hackensack University Medical Center
Hackensack, New Jersey

Mutahar Ahmed

Attending Urologist
Hackensack University Medical Center
Maywood, New York

Mutahar Ahmed MD FACS
Director of the Center for Bladder Cancer and Reconstructive Urologic Surgery at Hackensack University Medical Center, in Hackensack, NJ
Clinical Assitant Professor Hackensack Meridian Seton Hall School of Medicine
Clinical Assistant Professor Rutgers University School of Medicine

Gregory Lovallo

Attending Urologist
Hackensack University Medical Center
Maywood, New Jersey

Ravi Munver

Professor & Vice Chair
Hackensack University Medical Center
Hackensack, New Jersey

Michael D. Stifelman

Chairman - Department of Urology
Hackensack University Medical Center
Hackensack, New Jersey