Trends in renal function after radical nephrectomy

A multicentre analysis

Jae S. Chung, Nak H. Son, Seok Soo Byun, Sang E. Lee, Sung K. Hong, Chang W. Jeong, Sang C. Lee, Dong Wan Chae, Won S. Choi, Yong H. Park, Sung H. Hong, Yong J. Kim, Seok Ho Kang

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objective To evaluate serial changes in renal function by investigating various clinical factors after radical nephrectomy (RN). Patients and Methods The study population consisted of 2068 consecutive patients who were treated at multiple institutions by RN for renal cortical tumour without metastasis between 1999 and 2011. We measured the serial change in estimated glomerular filtration rate (eGFR) and clinical factors during a 60-month follow-up period. The changes in eGFR over time were analysed according to baseline eGFR (eGFR ≥60 and 15-59 mL/min/1.73m2) using a linear mixed model. The independent prognostic value of various clinical factors on the increase in eGFR was ascertained by multivariate mixed regression model. Results Overall, there was a subsequent restoration of renal function over the 60 months. The slope for the relationship between the eGFR and the time since RN was 0.082 (95% confidence interval [CI] 0.039-0.104; P < 0.001) and 0.053 (95% CI 0.006-0.100; P = 0.038) in each baseline group, indicating that each month after RN was associated with an increase in eGFR of 0.082 and 0.053 mL/min/1.73m2, respectively. When we analysed renal function based on various factors, postoperative eGFR of patients with diabetes mellitus, old age (≥70 years) or a preoperative eGFR of <30 mL/min/1.73 m2, was decreased or maintained at a certain level without any improvement in renal function. Preoperative predictors of an increase in eGFR after RN were young age, no DM, no hypertension, a preoperative eGFR of ≥30 mL/min/1.73m2 and time after surgery (≥36 months). Conclusions Renal function recovered continuously during the 60-month follow-up period after RN. However, the trends in functional recovery change were different according to various clinical factors and such information should be discussed with patients when being counselled about their treatment for renal cell carcinoma (RCC).

Original languageEnglish
Pages (from-to)408-415
Number of pages8
JournalBJU International
Volume113
Issue number3
DOIs
Publication statusPublished - 2014 Jan 1

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Nephrectomy
Glomerular Filtration Rate
Kidney
Confidence Intervals
Renal Cell Carcinoma
Linear Models
Diabetes Mellitus
Neoplasm Metastasis
Hypertension

Keywords

  • kidney function tests
  • nephrectomy
  • RCC
  • renal insufficiency

ASJC Scopus subject areas

  • Urology

Cite this

Chung, J. S., Son, N. H., Byun, S. S., Lee, S. E., Hong, S. K., Jeong, C. W., ... Kang, S. H. (2014). Trends in renal function after radical nephrectomy: A multicentre analysis. BJU International, 113(3), 408-415. https://doi.org/10.1111/bju.12277

Trends in renal function after radical nephrectomy : A multicentre analysis. / Chung, Jae S.; Son, Nak H.; Byun, Seok Soo; Lee, Sang E.; Hong, Sung K.; Jeong, Chang W.; Lee, Sang C.; Chae, Dong Wan; Choi, Won S.; Park, Yong H.; Hong, Sung H.; Kim, Yong J.; Kang, Seok Ho.

In: BJU International, Vol. 113, No. 3, 01.01.2014, p. 408-415.

Research output: Contribution to journalArticle

Chung, JS, Son, NH, Byun, SS, Lee, SE, Hong, SK, Jeong, CW, Lee, SC, Chae, DW, Choi, WS, Park, YH, Hong, SH, Kim, YJ & Kang, SH 2014, 'Trends in renal function after radical nephrectomy: A multicentre analysis', BJU International, vol. 113, no. 3, pp. 408-415. https://doi.org/10.1111/bju.12277
Chung JS, Son NH, Byun SS, Lee SE, Hong SK, Jeong CW et al. Trends in renal function after radical nephrectomy: A multicentre analysis. BJU International. 2014 Jan 1;113(3):408-415. https://doi.org/10.1111/bju.12277
Chung, Jae S. ; Son, Nak H. ; Byun, Seok Soo ; Lee, Sang E. ; Hong, Sung K. ; Jeong, Chang W. ; Lee, Sang C. ; Chae, Dong Wan ; Choi, Won S. ; Park, Yong H. ; Hong, Sung H. ; Kim, Yong J. ; Kang, Seok Ho. / Trends in renal function after radical nephrectomy : A multicentre analysis. In: BJU International. 2014 ; Vol. 113, No. 3. pp. 408-415.
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abstract = "Objective To evaluate serial changes in renal function by investigating various clinical factors after radical nephrectomy (RN). Patients and Methods The study population consisted of 2068 consecutive patients who were treated at multiple institutions by RN for renal cortical tumour without metastasis between 1999 and 2011. We measured the serial change in estimated glomerular filtration rate (eGFR) and clinical factors during a 60-month follow-up period. The changes in eGFR over time were analysed according to baseline eGFR (eGFR ≥60 and 15-59 mL/min/1.73m2) using a linear mixed model. The independent prognostic value of various clinical factors on the increase in eGFR was ascertained by multivariate mixed regression model. Results Overall, there was a subsequent restoration of renal function over the 60 months. The slope for the relationship between the eGFR and the time since RN was 0.082 (95{\%} confidence interval [CI] 0.039-0.104; P < 0.001) and 0.053 (95{\%} CI 0.006-0.100; P = 0.038) in each baseline group, indicating that each month after RN was associated with an increase in eGFR of 0.082 and 0.053 mL/min/1.73m2, respectively. When we analysed renal function based on various factors, postoperative eGFR of patients with diabetes mellitus, old age (≥70 years) or a preoperative eGFR of <30 mL/min/1.73 m2, was decreased or maintained at a certain level without any improvement in renal function. Preoperative predictors of an increase in eGFR after RN were young age, no DM, no hypertension, a preoperative eGFR of ≥30 mL/min/1.73m2 and time after surgery (≥36 months). Conclusions Renal function recovered continuously during the 60-month follow-up period after RN. However, the trends in functional recovery change were different according to various clinical factors and such information should be discussed with patients when being counselled about their treatment for renal cell carcinoma (RCC).",
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AU - Hong, Sung K.

AU - Jeong, Chang W.

AU - Lee, Sang C.

AU - Chae, Dong Wan

AU - Choi, Won S.

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