The 1-year decline in estimated glomerular filtration rate (eGFR) after radical nephrectomy in patients with renal masses and matched living kidney donors is the same

被引:11
作者
Hew, Miki N. [1 ]
Opondo, Dedan [1 ]
Cordeiro, Ernesto R. [1 ]
van Donselaar-van der Pant, Karlijn A. M. I. [2 ]
Bemelman, Frederike J. [2 ]
Idu, Mirza M. [2 ,3 ]
de la Rosette, Jean J. M. C. H. [2 ]
Laguna, M. Pilar [2 ]
机构
[1] Acad Med Ctr, Dept Urol, NL-1100 DD Amsterdam, Netherlands
[2] Acad Med Ctr, Renal Transplant Unit, Dept Internal Med, NL-1100 DD Amsterdam, Netherlands
[3] Acad Med Ctr, Dept Surg, NL-1100 DD Amsterdam, Netherlands
关键词
co-morbidity; renal function; renal cell carcinoma; nephrectomy; living donor; ESTIMATED GFR; DISEASE; OUTCOMES; IMPACT; GUIDELINES; MORBIDITY; TUMORS; AGE; INSUFFICIENCY; PROTEINURIA;
D O I
10.1111/bju.12345
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objectives To determine short-term differences in renal function evolution between patients with renal cell carcinoma (RCC) submitted to radical nephrectomy (RN) and living kidney donors matched for age and gender. To assess the role of co-morbidity as a risk factor for developing an estimated glomerular filtration rate (eGFR) of Patients and Methods In this retrospective study patients undergoing Radical Nefrectomy (RN) between January 2000 and February 2011 for suspicion of localised RCC were matched by age and gender to living kidney donors. Renal function was compared between the groups using the Modification in Diet and Renal Disease (MDRD) equation at 1 year after RN. Charlson co-morbidity score, incidence of hypertension, diabetes and cardiovascular disease were compared and assessed as predictors for developing an eGFR of Results In all, 196 patients were included, 98 in each group. The mean age was respectively 60.6 (RCC group) and 59.1 years (donors). The 1-year postoperative mean eGFR (available in 89 patients with RCC and 87 donors) was similar, at a mean (sd) of 56.7 (16.4) mL/min/1.73 m(2) in patients with RCC and 56.2 (9.8) mL/min/1.73 m(2) in donors (P = 0.83). In patients with RCC the incidence and severity of co-morbidities was significantly higher. A preoperative eGFR of 60-89 mL/min/1.73 m(2) was the only independent risk factor for developing a postoperative eGFR of <60 mL/min/1.73 m(2) (odds ratio 4.4, confidence interval 2.1-9.5, P < 0.001, 95% confidence interval). Conclusions In our cohorts with advanced age the 1-year follow-up eGFR was similar in both groups. Despite increased co-morbidity in the RCC group there was no increased decline in renal function. Only reduced preoperative eGFR could be identified as risk factor for developing a postoperative eGFR of
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页码:E49 / E55
页数:7
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