Laparoscopic/ Robotic: Other

Moderated Poster Session

MP16-10 - External validation of a preoperative nomogram for predicting renal function at 1 year after partial nephrectomy in an Asian population

Saturday, September 22
10:00 AM - 12:00 PM
Location: Room 243

Introduction & Objective :

Partial nephrectomy (PN) decreases the risk of post-operative chronic renal insufficiency (CRI) compared to radical nephrectomy. Nevertheless, a proportion of patients still progress to CRI after PN, necessitating renal replacement therapy. A tool to predict post-PN estimated glomerular filtration rates (eGFRs) would be helpful in counseling patients pre-operatively. Recently, Shum et al published a nomogram in 2017 predicting eGFRs 1 year after PN in an American population.(1) We sought to externally validate this nomogram in our Asian population.


Methods :

We identified patients who underwent PN at our institution between 2005 to 2014, with known post-operative serum creatinine levels at 1 year.  The pre-operative covariates were the same as those used in the paper published by Shum et al (2017)(1) . The endpoint was eGFRs at 1 year after PN, calculated using the modification of diet in renal disease (MDRD) formula, compared against the predicted eGFR 1 year after PN using the nomogram. The area under the curve (AUC) for the receiver operating characteristic (ROC) curve of the nomogram was calculated.


Results :

53 patients were suitable for analysis. 58% (n= 31) of them were male, while 42% (n=22) were female. The average body mass index (BMI) was 25.7 (± 4.9). The average pre-operative eGFR was 85.0 (± 30.6) while the average 1 year post-PN eGFR was 70.9 (± 25.6). The average age of our patients was 59.5 (± 10.6). The percentage of patients with eGFR below 60mL/min/1.73m2 increased from 20% before PN to 30% 1 year post-PN. External validation of the nomogram by Shum et al. (2017) showed an AUC of 0.81.  Of note, overestimation of predicted eGFRs 1 year post-PN was more apparent in the chronic kidney disease population.


Conclusions :

We have externally validated a nomogram using only preoperative covariates to predict renal function at 1 year after PN. This nomogram can serve as a valuable guide in managing and counseling our local patients considering PN.



References


1. Shum CF, Bahler CD, Cary C et al. Preoperative Nomograms for Predicting Renal Function at 1 Year After Partial Nephrectomy. J Endourol. 2017 Jul;31(7):711-718.doi:10.1089/end.2017.0184.

Marcus Way Lunn Chow

Resident
Tan Tock Seng Hospital

Dr Marcus Chow
MBChB (Edin), MRCS (Edin)
Resident
Tan Tock Seng Hospital

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    Daniel Zhan Peng Yong

    Senior resident
    Mohh

    Dr Daniel Yong
    MD, MEng, MBiot, MRCS, FAMS

    Associate Consultant, TTSH, Urology, Singapore
    Clinical tutor, NUS, LKC
    MD (Duke-NUS),
    MEng (Electrical and Electronics Engineering, Imperial College London, UK)
    MBiot (Biotechnology, University of Pennsylvania , U.S.A)
    MRCS (Edin)
    FAMS (Urology)

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      Jia Lun Kwok

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        Cheuk Fan Shum

        Consultant
        Khoo Teck Puat Hospital

        MBBS, MRCSEd, MMed (Surgery), FAMS (Urology)

        Consultant, Department of Urology, Khoo Teck Puat Hospital, Singapore

        Presentation(s):

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          Keng Siang Png

          Senior Consultant
          Department of Urology, Tan Tock Seng Hospital (Singapore)

          Presentation(s):

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