Assessing Time of Full Renal Recovery Following Minimally Invasive Partial Nephrectomy

Dawidek, Mark; Chan, Ernest; Boyle, Shawna L.; Şener, Alp; Luke, Patrick

doi:10.1016/j.urology.2017.10.004

Cited by 12 publications

(6 citation statements)

References 29 publications

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“…There is a paucity of evidence demonstrating the acceleration of recovery after a renal transplant, abdominopelvic surgery, and cancer surgery in general. 14 This is an opportunity for further investigation.…”

Section: Discussionmentioning

confidence: 96%

Accelerated Recovery After Renal Cell Carcinoma and Partial Nephrectomy With Lifestyle Modifications

Moore

2021

American Journal of Lifestyle Medicine

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Objective and subjective recovery times following a partial nephrectomy may exceed 1 year if patients adhere to the current Western lifestyle. This case demonstrates the rapid recovery of a 59-year-old female who underwent a robotic partial nephrectomy and utilized lifestyle modifications as an adjunct to the treatment of a Stage T1a clear cell renal cell carcinoma. All 6 pillars of lifestyle medicine are incorporated into this patient’s recovery plan, which successfully reduced her time to recovery after a partial nephrectomy. This case illustrates how modifications in diet, activity, sleep, stress management, social connectedness, and avoidance of risky substances may shorten recovery time after a partial nephrectomy and may serve as an example that providers can prescribe for patients recovering from other surgeries.

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Section: Discussionmentioning

confidence: 96%

Accelerated Recovery After Renal Cell Carcinoma and Partial Nephrectomy With Lifestyle Modifications

Moore

2021

American Journal of Lifestyle Medicine

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“…This definition also might increase the percentage of postoperative CKD (48%) as time was insufficient to full recovery. Recently, Dawidek and colleagues reported that the optimal renal function recovery following PN occurred by 6–12 weeks, and they concluded that this period should therefore be considered an appropriate endpoint for postoperative follow‐up 32 . Unlike to their analysis, 31 we included patients who underwent PN only and those with preoperative eGFR >60 ml/min/1.73m 2 , and this might explain the lower postoperative percentage (1.2%) of patients who have eGFR <45 ml/min/1.73m 2 .…”

Section: Discussionmentioning

confidence: 99%

External validation of yonsei nomogram predicting chronic kidney disease development after partial nephrectomy: An international, multicenter study

et al. 2022

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“…11 Similarly, Dawidek and colleagues demonstrated that 6-12-week post-op nuclear renography measurements in conjunction with eGFR did not differ from renal function parameters at 1 year, contributing more specific information on the operated kidney's contribution to renal function trajectory after Pnx. 18 Two other studies analyzed the predictive value of the long-term ''new baseline GFR,'' measured as the highest GFR obtained in the 6 weeks after nephrectomy. 9,19 Highlighting the importance of understanding long-term GFR trajectory, a 2015 study by Lane and coworkers determined a new baseline GFR of <45 mL/(minute $1.73 m 2 ) significantly predicted all-cause mortality for a period of 10 years.…”

Section: Discussionmentioning

confidence: 99%

Does Glomerular Filtration Rate at Discharge After Partial Nephrectomy Predict Long-Term Glomerular Filtration Rate Stability?

Bernstein

Barry

Fram

et al. 2019

Journal of Endourology

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Introduction: Being able to predict glomerular filtration rate (GFR) plateau after partial nephrectomy (Pnx) is an important goal in providing patients with a confident projection of maintained renal function. As such, in an ethnically and socioeconomically diverse, inner city cohort of patients undergoing Pnx, we compared preoperative (pre-op) and day of discharge (DC) GFR to that of long-term GFR measured at 12-18 months to evaluate postoperative (post-op) GFR stability. Methods: A total of 162 patients who had undergone minimally invasive Pnx at a single institution between 2010 and 2016 were reviewed. Patients with the following available measurements were included: pre-op GFR, DC GFR, and long-term GFR (12-18 months after DC). Multivariate linear regression was performed to assess factors predictive of long-term GFR, including estimated blood loss, warm ischemic time, tumor size, length of stay, pre-op GFR, DC GFR, race, chronic kidney disease, diabetes mellitus, and hypertension. Results: Mean pre-op GFR, DC GFR, and long-term GFR were 70.754, 68.326, and 66.526 mL/(minute $ 1.73 m 2), respectively. Mean GFR change was-4.228 pre-op to long term and-1.800 DC to long term. No significant difference was observed between means of DC GFR and long-term GFR (p = 0.248) as well as between means of pre-op GFR and DC GFR (p = 0.062). A significant difference was observed between pre-op GFR and long-term DC GFR (p = 0.002). On multivariate analysis, both pre-op GFR (b = 0.532; 95% confidence interval [CI] = 0.256-0.808; p £ 0.001) and DC GFR (b = 0.312; 95% CI = 0.089-0.537; p = 0.007) were found to be strong predictors of long-term GFR (R 2 = 0.608). Conclusions: Long-term GFR in a highly ethnically diverse inner city population recovering from Pnx is stable relative to GFR measured at DC from the hospital. Our findings demonstrate that patients experience a GFR plateau after surgery, resulting in minimal change in renal function at a mean of 14 months post-op.

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Assessing Time of Full Renal Recovery Following Minimally Invasive Partial Nephrectomy

Cited by 12 publications

References 29 publications

Accelerated Recovery After Renal Cell Carcinoma and Partial Nephrectomy With Lifestyle Modifications

Accelerated Recovery After Renal Cell Carcinoma and Partial Nephrectomy With Lifestyle Modifications

External validation of yonsei nomogram predicting chronic kidney disease development after partial nephrectomy: An international, multicenter study

Does Glomerular Filtration Rate at Discharge After Partial Nephrectomy Predict Long-Term Glomerular Filtration Rate Stability?

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