Clinical predictors of the estimated glomerular filtration rate 1 year after radical nephrectomy in Japanese patients

Abstract

PurposeTo evaluate renal function 1 year after radical nephrectomy (RN) for renal cell carcinoma, the preoperative predictors of postnephrectomy renal function were investigated by sex, and equations to predict the estimated glomerular filtration rate (eGFR) 1 year after RN were developed.Materials and MethodsA total of 525 patients who underwent RN between May 2007 and August 2011 at Tohoku University Hospital and its affiliated hospitals were prospectively evaluated. Overall, 422 patients were analyzed in this study.ResultsIndependent preoperative factors associated with postnephrectomy renal function were different in males and females. Preoperative eGFR, age, tumor size, and body mass index (BMI) were independent factors in males, while tumor size and BMI were not independent factors in females. The equations developed to predict eGFR 1 year after RN were: Predicted eGFR in males (mL/min/1.73 m2)=27.99−(0.196×age)+(0.497×eGFR)+(0.744×tumor size)−(0.339×BMI); and predicted eGFR in females=44.57−(0.275×age)+(0.298×eGFR). The equations were validated in the validation dataset (R2=0.63, p<0.0001 and R2=0.31, p<0.0001, respectively).ConclusionsThe developed equations by sex enable better prediction of eGFR 1 year after RN. The equations will be useful for preoperative patient counseling and selection of the type of surgical procedure in elective partial or RN cases.

Changes in Renal Function One Year after Radical Nephrectomy for Cancer Compared to Kidney Donation

“…Despite a reported loss of 30% in glomerular filtration rate following unilateral nephrectomy, only 0.3 to 0.5% of kidney donors progressed to end stage CKD with need for renal replacement therapy [1,3]. However, for patients submitted to radical nephrectomy for cancer, rates of CKD are higher, around 40 to 75% to stage 3 and 1 to 2% of end stage CKD [4][5][6]. These differences can be related to patient characteristics and associated risk factors, such as age at the time of nephrectomy and the presence of comorbidities like hypertension and diabetes [7,8].…”