Metabolic Syndrome Predicts Worse Perioperative Outcomes in Patients Treated With Partial Nephrectomy for Renal Cell Carcinoma

Luzzago, Stefano; Palumbo, Carlotta; Rosiello, Giuseppe; Pecoraro, Angela; Deuker, Marina; Stolzenbach, Franziska; Mistretta, Francesco A.; Tian, Zhe; Musi, Gennaro; Montanari, Emanuele; Shariat, Shahrokh F.; Saad, Fred; Briganti, Alberto; Cobelli, Ottavio De; Karakiewicz, Pierre I.

doi:10.1016/j.urology.2020.02.019

Cited by 4 publications

(2 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is also a link between RCC outcomes and metabolomic syndrome defined as being obese and having hypertension, diabetes, and hyperlipidemia. Previous studies have shown that metabolic syndrome is associated with complications, transfusion, conversion to open surgery, and poor survival ( 21 , 59 - 61 ). Furthermore, racial and ethnic minority patients and patients with comorbidities are more likely to undergo radical rather than partial nephrectomy ( 33 - 36 , 62 ).…”

Section: Discussionmentioning

confidence: 99%

Differential effects of obesity on perioperative outcomes in renal cell carcinoma patients based on race and ethnicity and neighborhood-level socioeconomic status

Asif,

Paster,

Pulling

et al. 2024

Transl Androl Urol

View full text Add to dashboard Cite

Background Obesity is a well-established risk factor of renal cell carcinoma (RCC), however the impact of obesity on surgical outcomes for racial and ethnic minority patients with RCC is unclear. This study investigated whether a higher body mass index (BMI) or obesity (BMI ≥30 kg/m 2 ) was associated with worse perioperative outcomes and if there were heterogeneous effects based on race, ethnicity, and neighborhood-level socioeconomic factor. Methods In this single-center cross-sectional study, medical records of patients who underwent partial or radical nephrectomy between 2010 and 2022 were retrospectively reviewed. Logistic regression analysis was performed to assess associations of BMI and perioperative outcomes [ischemia time, estimated blood loss (EBL), and length of hospital stay]. Results A total of 432 patients, including 49.8% non-Hispanic White (NHW), 35.0% Hispanic, and 6.9% American Indian (AI) patients, were included. Median [interquartile range (IQR)] BMI was 30.2 (26.3–35.2) kg/m 2 , and Hispanic (31.5) and AI (32.5) patients had higher median BMI than NHW (29.1) patients (P=0.006). Median ischemia time, EBL, and length of hospital stay were 18.5 (IQR, 15.0–22.4) minutes, 150 (IQR, 75.0–300.0) mL, and 3 (IQR, 2–5) days. BMI ≥35 kg/m 2 was associated with a longer ischemia time [>18.5 minutes; odds ratio (OR), 5.17; 95% confidence interval (CI): 1.81–14.76; P=0.002], and the association was stronger in NHW than Hispanic patients (BMI continuous OR, 1.13; 95% CI: 1.04–1.22; P=0.004 in NHW and OR, 1.07; 95% CI: 0.98–1.17; P=0.12 in Hispanics). Class I and II/III obese patients had over two-fold increased odds of a larger EBL (>150 mL) than patients with normal weight (OR, 2.17; 95% CI: 1.03–4.59; P=0.04 for class I and OR, 2.24; 95% CI: 1.04–4.84; P=0.04 for class II/III obese patients). This association was stronger in patients from neighborhoods with high social deprivation index (SDI) and in NHW patients (BMI ≥30 vs. <30 kg/m 2 , OR, 3.53; 95% CI: 1.57–7.97; P=0.002 in high SDI neighborhoods and OR, 2.38; 95% CI: 1.10–5.14; P=0.03 in NHW). BMI was not associated with a longer hospital stay. Conclusions In this study, obesity increased likelihood of worse perioperative outcomes, and the associations varied based on race and ethnicity and neighborhood-level socioeconomic factors.

show abstract

Section: Discussionmentioning

confidence: 99%

Differential effects of obesity on perioperative outcomes in renal cell carcinoma patients based on race and ethnicity and neighborhood-level socioeconomic status

Asif,

Paster,

Pulling

et al. 2024

Transl Androl Urol

View full text Add to dashboard Cite

show abstract

“…Only based on univariate analysis, patients without MetS had less risk of postoperative kidney dysfunction (OR = 0.22, 95% CI: 0.05, 0.73. p = 0.024) and postoperative AKI (OR = 0.23, 95% CI: 0.08, 0.60, p = 0.004). Other studies also did not indicate MetS as a direct AKI predictor, but it can strongly predict perioperative complications after PN [ 37 ]. The strength of the effect was directly proportional to the number of MetS components, even if MetS criteria had not been normally matched.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Renal Function after Partial Nephrectomy and Detection of Clinically Significant Acute Kidney Injury

et al. 2022

View full text Add to dashboard Cite

Background and Objectives: Consequences of partial nephrectomy (PN), intraoperative hypotension (IOH) and postoperative neutrophil to lymphocyte ratio (NLR) may cause postoperative acute kidney injury (AKI) and in long-term-chronic kidney disease (CKD). Our study aimed to identify the AKI incidence after PN, to find clinically significant postoperative AKI and renal dysfunction, and to determine the predictor factors. Materials and Methods: A prospective observational study consisted of 91 patients who received PN with warm ischemia, and estimated preoperative glomerular filtration rate (eGFR) ≥ 60 mL/min and without abnormal albuminuria. Results: 38 (41.8%) patients experienced postoperative AKI. Twenty-one (24.1%) patients had CKD upstage after 1 year follow-up. Sixty-seven percent of CKD upstage patients had AKI 48 h after surgery and 11% after 2 months. All 15 (16.5%) patients with CKD had postoperative AKI. With IOH, OR 1.07, 95% CI 1.03–1.10 and p < 0.001, postoperative NLR after 48 h (OR 1.50, 95% CI 1.19–1.88, p < 0.001) was the major risk factor of AKI. In multivariate logistic regression analysis, the kidney’s resected part volume (OR 1.08, 95% CI 1.03–1.14, p < 0.001) and IOH (OR 1.10, 95% CI 1.04–1.15, p < 0.001) were retained as statistically significant prognostic factors for detecting postoperative renal dysfunction. The independent risk factor for clinically significant postoperative AKI was only IOH (OR, 1.06; p < 0.001). Only AKI with the CKD upstage group has a statistically significant effect (p < 0.0001) on eGFR 6 and 12 months after surgery. Conclusions: The presence of AKI after PN is not rare. IOH and NLR are associated with postoperative AKI. The most important predictive factor of postoperative AKI is an NLR of over 3.5. IOH is an independent risk factor for clinically significant postoperative AKI and together with kidney resected part volume effects postoperative renal dysfunction. Only clinically significant postoperative AKI influences the reduction of postoperative eGFR after 6 and 12 months.

show abstract

Efficacy and feasibility of robot-assisted partial nephrectomy for octogenarians: comparison with younger counterparts

et al. 2022

View full text Add to dashboard Cite

Metabolic Syndrome Predicts Worse Perioperative Outcomes in Patients Treated With Partial Nephrectomy for Renal Cell Carcinoma

Abstract: Metabolic syndrome predicts worse perioperative outcomes in patients treated with partial nephrectomy for renal cell carcinoma, Urology (2020), doi:

Cited by 4 publications

References 28 publications

Differential effects of obesity on perioperative outcomes in renal cell carcinoma patients based on race and ethnicity and neighborhood-level socioeconomic status

Differential effects of obesity on perioperative outcomes in renal cell carcinoma patients based on race and ethnicity and neighborhood-level socioeconomic status

Evaluation of Renal Function after Partial Nephrectomy and Detection of Clinically Significant Acute Kidney Injury

Efficacy and feasibility of robot-assisted partial nephrectomy for octogenarians: comparison with younger counterparts

Contact Info

Product

Resources

About