Details

Autor(en) / Beteiligte

• Takagi, Toshio
• Kondo, Tsunenori
• Iizuka, Junpei
• Tomita, Eri
• Kobayashi, Hirohito
• Hashimoto, Yasunobu
• Tanabe, Kazunari

Titel

Predictors for postoperative renal function after open partial nephrectomy: Including postoperative biomarkers

Ist Teil von

• International journal of urology, 2012-09, Vol.19 (9), p.823-828

Ort / Verlag

Melbourne, Australia: Blackwell Publishing Asia

Erscheinungsjahr

2012

Quelle

Wiley Online Library - AutoHoldings Journals

Beschreibungen/Notizen

• Objectives:  To assess the predictors of postoperative renal insufficiency after open partial nephrectomy. Methods:  A total of 195 patients who underwent open partial nephrectomy were the participants in this study. Patients with a decrease in the estimated glomerular filtration rate of >25% from baseline were evaluated on the basis of multiple factors including patient‐specific, surgical, tumor and postoperative factors. Postoperative estimated glomerular filtration rate data were recorded between 3 and 6 months after surgery. Results:  Of the 195 patients, 18 (9%) had a decrease in estimated glomerular filtration rate of >25%. Percentage of preserved renal parenchyma (P = 0.0078), nearness of tumor to renal sinus (P = 0.0108), location of tumor to middle part of kidney (P = 0.0112), postoperative highest lactase dehydrogenase (P < 0.0001), postoperative body temperature (P = 0.0314) and postoperative acute kidney injury (P < 0.0001) were significantly different between patients with a decrease in estimated glomerular filtration rate of >25% and those with a decrease in estimated glomerular filtration rate ≤25% on univariate analysis. Multivariate analysis showed that postoperative highest lactase dehydrogenase (P = 0.0408) and acute kidney injury (P = 0.0002) were independent predictors for decrease of estimated glomerular filtration rate >25%. In contrast, patient characteristic factors (chronic kidney disease stage), surgical factors (clamping time and PPRP) and tumor factors (radius, endophytic/exophytic, nearness and location component) were not significant predictors. Conclusions:  Postoperative factors, lactase dehydrogenase and acute kidney injury, were strong predictors for renal insufficiency after open partial nephrectomy. Thus, a strict follow up is advisable in patients showing high postoperative levels of these two biomarkers.