Obesity, hypertension and diabetes mellitus affect complication rate of different nephrectomy techniques

Hua, Xing; Cheng, Yingying; Zu-Jun, F.; Xie, Gang; Zu-Quan, X.; 丁强,; Jiang, Hanqiang

doi:10.1016/j.acuroe.2014.10.003

Cited by 6 publications

(7 citation statements)

References 30 publications

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“…The association between MetS and early adverse perioperative outcomes after PN has been poorly investigated [5][6][7][8][9] . However, obesity 10,[12][13][14][15]17 , hypertension 20,21 and diabetes 21,[23][24][25] have been previously related to higher complication rates after PN.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, MetS is associated with aggressive pathological features of renal cell carcinoma (RCC) 3,4 . However, there are no robust data to indicate whether or not MetS predicts early adverse outcomes after partial nephrectomy (PN) [5][6][7][8][9] . Nonetheless, several previous reports examined the effect of individual MetS components, namely either obesity [10][11][12][13][14][15][16][17][18] or hypertension [19][20][21] or diabetes [21][22][23][24][25] , on perioperative outcomes after PN, without adjusting for possible combined effect of other MetS components.…”

Section: Introductionmentioning

confidence: 99%

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

Luzzago

Palumbo

Rosiello

et al. 2020

Urology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Luzzago

Palumbo

Rosiello

et al. 2020

Urology

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“…This becomes even more important in the presence of obesity, a severe problem in the Western society, often associated with fatal diseases [24]. Although genetic factors may increase the propensity to obesity, epidemiological evidence identified a strong correlation with a diet rich in fat [25], which is often associated with a significant increase in CV risk [26]. In this regard, the industrial research on nutrition is constantly attempting to formulate innovative products that are a perfect balance between fat content and health.…”

Section: Discussionmentioning

confidence: 99%

The innovative “Bio-Oil Spread” prevents metabolic disorders and mediates preconditioning-like cardioprotection in rats

Quintieri

Filice

Amelio

et al. 2016

Nutrition, Metabolism and Cardiovascular Diseases

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Background and aims: Obesity is often associated with an increased cardiovascular risk. The food industry and the associated research activities focus on formulating products that are a perfect mix between an adequate fat content and health. We evaluated whether a diet enriched with Bio-Oil Spread (SD), an olive oil-based innovative food, is cardioprotective in the presence of high-fat diet (HFD)-dependent obesity.Methods and Results: Rats were fed for 16 weeks with normolipidic diet (ND; fat: 6.2%), HFD (fat: 42%), and ND enriched with SD (6.2% of fat þ 35.8% of SD). Metabolic and anthropometric parameters were measured. Heart and liver structures were analyzed by histochemical examination. Ischemic susceptibility was evaluated on isolated and Langendorff-perfused cardiac preparations. Signaling was assessed by Western blotting. Compared to ND rats, HFD rats showed increased body weight and abdominal obesity, dyslipidemia, and impaired glucose tolerance. Morphological analyses showed that HFD is associated with heart and liver modifications (hypertrophy and steatosis, respectively), lesser evident in the SD group, together with metabolic and anthropometric alterations. In particular, IGF-1R immunodetection revealed a reduction of hypertrophy in SD heart sections. Notably, SD diet significantly reduced myocardial susceptibility against ischemia/reperfusion (I/R) with respect to HFD through the activation of survival signals (Akt, ERK1/2, and Bcl2). Systolic and diastolic performance was preserved in the SD group. Conclusions: We suggest that SD may contribute to the prevention of metabolic disorders and cardiovascular alterations typical of severe obesity induced by an HFD, including the increased ischemic susceptibility of the myocardium. Our results pave the way to evaluate the introduction of SD in human alimentary guidelines as a strategy to reduce saturated fat intake. IntroductionMen and women of all ages, races, and ethnic groups can be affected by obesity [1] and this is often accompanied by an increased morbidity and mortality due an increase of cardiovascular disease (CVD) risk factors [2,3]. Severe obesity causes permanent hemodynamic alterations that progressively impair cardiac structure and function. When comorbidities (i.e., systemic hypertension, sleep apnea, and hypoventilation) are present together with obesity, cardiac alterations progress to heart failure (HF) [4]. Metabolic syndrome (MetS) is a condition in which a high CVD risk is associated with obesity. It is characterized by disturbed glucose homeostasis, dyslipidemia, and hypertension [5] and is established in the presence of three of the following parameters: (i) waist circumference >40 (men) and >35 (women) inches; (ii) triglycerides >150 mg/dl; (iii) HDL (high-density lipoprotein) cholesterol <40 (men) and <50 (women) mg/dl; (iv) blood pressure >130/85 mm Hg; and (v) fasting glucose >100 mg/dl [6]. Currently, nutritional therapy is regarded as the best practice to prevent and/or reduce the cardiovascular damages associated ...

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“…In the urologic literature, poor preoperative nutritional status appears to be strongly associated with oncologic outcomes following surgery, including cancer-specific and overall survival [9,[14][15][16][17][18]. Additionally, among patients with metastatic RM undergoing cytoreductive nephrectomy, malnutrition as defined by hypoalbuminemia has been associated with perioperative mortality [15].…”

Section: Introductionmentioning

confidence: 99%

“…However, beyond this report, the association between preoperative nutritional status and early postoperative morbidity and mortality following PN and RN across stages of RM remains inadequately characterized. Furthermore, there is conflicting data regarding associations between obesity, as defined by BMI >30 kg/m 2 , and perioperative outcomes after PN and RN, as some authors have reported increased perioperative morbidity among patients with obesity [16,17], while other reports have failed to find any such association [16,19,20].…”

Section: Introductionmentioning

confidence: 99%

Nutritional Predictors of Perioperative Complications and Mortality Following Nephrectomy for Renal Malignancies: A Population-Based Analysis

Arora

Hanson

Habermann

et al. 2018

KCA

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Introduction and Objective: Conflicting data exists regarding the impact of body mass index (BMI) on postoperative outcomes following surgery for renal malignancies (RM). Herein, we investigated associations between obesity, hypoalbuminemia, and/or significant weight loss in the preoperative period, and risk complications and mortality within 30 days of radical (RN) or partial nephrectomy (PN). Materials and Methods: Review of the American College of Surgeons National Surgical Quality Improvement Program database identified 8,618 patients treated with PN or RN for RM between 2005 and 2012. Univariate and multivariable logistic regression models were developed to assess associations between hypoalbuminemia (<3.5 g/dl), >10% weight loss within 6 months of surgery, obesity (BMI >30 kg/m 2), and 30-day major complications and mortality. Results: Median BMI was 29.2 kg/m 2 with 24.9%, 11.9%, and 8.2% having class I, II, and III obesity, respectively. Weight loss of >10% was observed in 2.6% and 15.4% had preoperative albumin<3.5 g/dl. There were 1,802 complications (20.9%) and 88 deaths within 30 days (1.0%). On multivariable analysis, BMI ≥40 kg/m 2 (OR 1.3, p = 0.04), >10% weight loss (OR 1.9, p < 0.001) and hypoalbuminemia (OR 1.5, p < 0.001) were independently associated with 30-day complications, while only >10% weight loss was independently associated with 30-day mortality (OR 2.4, p = 0.03). Conclusions: Extreme obesity, hypoalbuminemia, and significant weight loss were independently associated with risk of significant complications following PN or RN while only significant preoperative weight loss was associated with early mortality, underscoring the need to further understand the utility of moderating these risk factors in the perioperative period.

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Obesity, hypertension and diabetes mellitus affect complication rate of different nephrectomy techniques

Cited by 6 publications

References 30 publications

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

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

The innovative “Bio-Oil Spread” prevents metabolic disorders and mediates preconditioning-like cardioprotection in rats

Nutritional Predictors of Perioperative Complications and Mortality Following Nephrectomy for Renal Malignancies: A Population-Based Analysis

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