Impact of short warm ischemic time on longitudinal kidney function and survival rate after partial nephrectomy for renal cell carcinoma in patients with pre-existing chronic kidney disease stage III: A multi-institutional propensity score-matched study

Jae Seung Chung, Sung Kyu Hong, Sang Chul Lee, Chang Wook Jeong, Cheol Kwak, Hyeon Hoe Kim, Sung Hoo Hong, Yong June Kim, Seok Ho Kang, Jinsoo Chung, Tae Gyun Kwon, Eu Chang Hwang, Seok Soo Byun

Research output: Contribution to journalArticle

Abstract

Purpose: It remains unclear whether a short warm ischemic time (WIT) improves long-term renal function after partial nephrectomy (PN) for patients with pre-existing chronic kidney disease (CKD). We evaluated renal function after PN according to WIT duration in patients with stage III CKD. Materials and methods: We identified 277 patients with stage III CKD who underwent PN during 2004–2017. Propensity score matching was used to created two matched groups of patients: Group A (WIT of <25 min) and Group B (WIT of ≥25 min). The outcomes of interest were longitudinal kidney function change, new-onset stage IV CKD (eGFR <30 mL/min/1.73 m2) and overall survival. Results: The two matched groups contained 85 patients each. The median follow-up durations were 49 months in Group A and 42 months in Group B. The median pre-treatment eGFRs were 52.4 mL/min/1.73 m2 in Group A and 52.6 mL/min/1.73 m2 in Group B. There were no differences in kidney function between the two groups throughout the follow-up period (P > 0.05). The 5-year rates of new-onset stage IV CKD were not significantly different between Group A and Group B (8.2% vs. 7.1%), with no significant difference in the risk of developing stage IV CKD in Group A (vs. group B, hazard ratio: 0.527, 95% confidence interval: 0.183–1.521; P = 0.236). The 5-year overall survival rates were 90.3% for Group A and 96.2% for Group B (P = 0.549). Conclusions: A short WIT was not associated with better postoperative kidney function or survival after PN in patients with stage III CKD.

Original languageEnglish
JournalEuropean Journal of Surgical Oncology
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • Carcinoma
  • Chronic kidney disease
  • Nephrectomy
  • Renal cell
  • Warm ischemia

ASJC Scopus subject areas

  • Surgery
  • Oncology

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