Presentation Authors: Takashi Ikeda*, Toshio Takagi, Hiroki Ishihara, Hironori Fukuda, Kazuhiko Yoshida, Junpei Iizuka, Hirohito Kobayashi, Masayoshi Okumi, Hideki Ishida, Tsunenori Kondo, Kazunari Tanabe, Tokyo, Japan
Introduction: Renal function preservation is an important goal of partial nephrectomy (PN). Renal function after PN declines owing to ischemic injury and loss of parenchymal volume. Although a relatively long-term follow-up of renal function after PN has been reported, renal function change in a robust number of patients from a single institution is rarely reported. In the present study, we assessed renal function change after PN for more than 3 years and analyzed the predictive factors for the development of chronic kidney disease (CKD) stage.
Methods: The data from 741 patients who underwent PN between 2003 and 2018 and who could be followed up for at least 3 years was retrospectively evaluated. The preoperative and postoperative estimated glomerular filtration rate (eGFR) was calculated and predictors associated with the development of CKD were studied using the univariate and multivariate logistic regression analyses.
Results: The patients&[prime] mean age was 60 years, and the mean tumor size was 30 mm. The numbers of open PNs, laparoscopic PNs, and robot-assisted laparoscopic PNs were 472 (63.7%), 146 (19.7%), and 123 (16.6%), respectively. The median eGFRs before PN and 3, 6, 12, 24, and 36 months after PN were 68.5, 60.8, 61.0, 61.1, 59.6, and 59.7 ml/min/1.73 m2, respectively. The numbers of patients who developed CKD at 6, 12, 24, and 36 months after PN were 243, 69, 56, and 37, respectively. Multivariate analysis revealed that age (≥60 vs. < 60 years: hazard ratio, 1.38, p = 0.0016), tumor size (â‰¥30 mm vs. < 30 mm: hazard ratio, 1.28, p = 0.0308), and surgical procedure (robot assisted vs. laparoscopic: hazard ratio, 1.41, p = 0.0511; robot-assisted vs. open PN: hazard ratio, 1.40; p = 0.0197) were independent predictors for the development of CKD.
Conclusions: Three years&[prime] follow-up after PN revealed that 405 patients (54.7%) developed CKD. Age, tumor size, and surgical procedure were independent predictors of the development of CKD after PN.