1189 Histopathologic Evaluation of Non-Neoplastic Renal Parenchyme Adjacent to Tumor in Partial Nephrectomy Specimens for Renal Cell Carcinoma

Abstract

patients with a single renal mass ¡Â 4cm in size undergoing PN or radical nephrectomy RN with the existence of a normal contralateral kidney were retrospectively reviewed from four major tertiary teaching hospitals. Estimated glomerular filtration rate (eGFR) was used to define the CKD less than 60ml/min per 1.73 m2 by the Modification of Diet in Renal Disease (MDRD) equation. Demographics and clinicopathologic parameters were evaluated using multivariate analysis to determine the risk factors independently affected with the development of CKD before and after the operation. RESULTS: Among the 1928 patients with a single small renal mass, CKD was found preoperatively in 10.0%, and 16.1% of patients developed CKD postoperatively. For 447 patients over 65 years of age, 87 (19.5%) patients were found to have CKD at baseline, while 102 (28.4%) new patients developed CKD after the operation. After multivariate analyses for the CKD's risk factors between the non-CKD and CKD patients, male gender (OR 3.54, pϭ.003 vs. OR 3.88 pϽ.001, respectively), and diagnostic age (OR 1.04, pϽ.001 vs. OR 3.88, pϽ.001), were significantly distinctive common risk factors both before and after the operation. In addition, hypertension (OR 0.46, pϭ.006), serum albumin (OR 0.228, pϽ.001), and calcium (OR 2.00, pϭ.023) are also significant for preoperative risk factors of CKD before operation, as well as preoperative serum creatinine (OR 1.28, pϽ.001) and surgical types (radical or partial nephrectomy) (OR 8.2, pϽ.001) for postoperative risk factors of CKD.CONCLUSIONS: This study indicates that those patients with a small renal mass and with the normal contralateral kidney should be carefully evaluated for their preoperative renal function to prevent the postoperative CKD if they were male with a history of hypertension, especially for the old ages. In addition, PN should first be considered rather than RN in consideration of developing postoperative CKD.