Is the R.E.N.A.L. Nephrometry Scoring System Predictive of the Functional Efficacy of Nephron Sparing Surgery in the Solitary Kidney?

Buethe, David D.; Moussly, Sammy; Lin, Hui‐Yi; Yue, Binglin; Rodríguez, Alejandro; Spiess, Philippe E.; Sexton, Wade J.

doi:10.1016/j.juro.2012.04.115

Cited by 32 publications

(25 citation statements)

References 29 publications

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“…Unfortunately, some previous reports have shown that the C index, PADUA and R.E.N.A.L. nephrometry score cannot predict postoperative RFL, 10,12,13 although a few previous studies have shown that all three scoring systems are significantly associated with the percentage change in creatinine level, 14,15 as well as warm ischemia time and tumour size. 14 Therefore, in the present study, we developed a highly accurate index to predict the postoperative RFL following LPN.…”

Section: Discussionmentioning

confidence: 93%

“…So far, several studies have validated the accuracy of these anatomical scores in predicting postoperative RFL; however, the ability of these scoring systems to predict postoperative RFL is still controversial. 10,[12][13][14][15] Some previous studies have indicated that these scoring systems fail to predict RFL after LPN 10,12,13 and that there are few indices designed to predict RFL after LPN. Accurate prediction of RFL after LPN is crucial when choosing the optimal treatment for renal tumours and minimizing RFL during LPN.…”

Section: Introductionmentioning

confidence: 99%

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Modified C index: Novel predictor of postoperative renal functional loss of laparoscopic partial nephrectomy

Ito

Makiyama

Kawahara

et al. 2017

CUAJ

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Introduction: We aimed to develop a scoring system to quantify the distance between the renal hilum and renal tumour, termed the modified C index (m-CI), and to predict renal functional loss (RFL) following laparoscopic partial nephrectomy (LPN). Methods: The m-CI was measured by using computed tomography in 113 patients who underwent LPN between May 2003 and June 2014. The RFL following LPN was calculated by examining the estimated glomerular filtration rate (eGFR) and radioisotope renography one year postoperatively. The Pythagorean theorem was used to calculate the distance from the tumour centre to the renal hilum. The distance was divided by the tumour radius to obtain the m-CI. The correlation between the m-CI and the postoperative RFL were evaluated using Pearson's coefficient values. Multivariate logistic regression models were used to assess the potential predictive factors of RFL following LPN. The correlation between the m-CI and the operative time, ischemia time, and blood loss during LPN were also evaluated by the unpaired t-test. Results: Pearson's coefficient values between the postoperative RFL and the m-CI and C index were 0.294 and 0.173, respectively. In the multivariate analysis, the resected volume (p=0.031) and m-CI (p=0.036) significantly correlated with the postoperative RFL following LPN. The operative time (p<0.001), ischemia time (p=0.028), and blood loss (p=0.047) during LPN was significantly longer and larger, respectively, in the group with shorter m-CI (≤4.5) than in the group with the longer m-CI (>4.5). Conclusions:The present study demonstrates that the m-CI can predict RFL following LPN, as well as the surgical difficulty.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Modified C index: Novel predictor of postoperative renal functional loss of laparoscopic partial nephrectomy

Ito

Makiyama

Kawahara

et al. 2017

CUAJ

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“…Previous studies reported that the decrease rate of postoperative eGFR was from 6% to 16%, [8][9][10][11] and the incidence of AKI requiring dialysis was from 4% to 5% after PN in solitary kidneys. 10,12 Our outcomes were comparable with these. Mannitol is an intravascular volume expander that can also function as a free radical scavenger, as well as an osmotic diuretic.…”

Section: Discussionmentioning

confidence: 95%

Mannitol has no impact on renal function after open partial nephrectomy in solitary kidneys

et al. 2013

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Abbreviations & AcronymsAbstract: Mannitol has been administered during partial nephrectomy as a renal protective agent for ischemic damage. However, we do not have any high-level clinical evidence of its effectiveness. The aim of the present study was to evaluate the effect of mannitol during open partial nephrectomy by comparing the postoperative renal function of patients who received it and those who did not. We retrospectively reviewed the records of 55 patients who underwent open partial nephrectomy for renal cancer in a solitary kidney from January 1990 to December 2012, and who were followed up postoperatively for at least 6 months. Of the 55 patients, mannitol was given to 20 patients (group M+) and not to the other 35 patients (group M−). We compared not only the postoperative estimated glomerular filtration rate, but also its decrease rate and the incidence of acute kidney injury requiring dialysis in the two groups. There were no significant differences in perioperative patient characteristics between the two groups. Mannitol made no significant difference in both the postoperative estimated glomerular filtration rate and its decrease rate at any point within 6 months of the postoperative period. The incidence of acute kidney injury requiring dialysis was one (5.0%) in group M+ and two (5.7%) in group M−. These findings suggest that there might be no advantage from the administration of mannitol during open partial nephrectomy.

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“…Отмечена корреляция развития острого сниже-ния почечной функции в раннем послеоперационном периоде с низкой исходной СКФ (r = -0,246; p = 0,008), вовлечением синуса почки в опухолевый процесс ОНКОУРОЛОГИЯ 3'2017 ТОМ 13 CANCER UROLOGY 3'2017 VOL. 13 (r = 0,214; p = 0,019), ишемией почечной паренхимы на резекционном этапе (r = 0,262; p = 0,002), ее временем (r = 0,334; p = 0,015) и объемом кровопотери (r = 0,188; p = 0,036).…”

Section: результатыunclassified

“…D. D. Buethe и соавт. (2012) не выявили влияния суммы баллов по шкале RENAL и отдельных компонентов этой нефрометри-ческой шкалы на функциональные результаты резек-ции единственной почки у 42 больных [13].…”

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Functional results of partial nephrectomy in solitary functioning kidney tumors

Volkova¹,

Alborov²,

Черняев³

et al. 2017

Cancer Urology

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Is the R.E.N.A.L. Nephrometry Scoring System Predictive of the Functional Efficacy of Nephron Sparing Surgery in the Solitary Kidney?

Cited by 32 publications

References 29 publications

Modified C index: Novel predictor of postoperative renal functional loss of laparoscopic partial nephrectomy

Modified C index: Novel predictor of postoperative renal functional loss of laparoscopic partial nephrectomy

Mannitol has no impact on renal function after open partial nephrectomy in solitary kidneys

Functional results of partial nephrectomy in solitary functioning kidney tumors

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