PREDICTIVE FACTORS FOR CHRONIC RENAL FAILURE AFTER PARTIAL NEPHRECTOMY IN SOLITARY KIDNEY: MULTICENTRIC STUDY IN 259 CASES

You have accessJournal of UrologyKidney Cancer: Evaluation and Staging I1 Apr 2012578 PREDICTIVE FACTORS FOR CHRONIC RENAL FAILURE AFTER PARTIAL NEPHRECTOMY IN SOLITARY KIDNEY: MULTICENTRIC STUDY IN 259 CASES Gregory Verhoest, Thomas Bessede, Geraldine Pignot, Rachid Bahi, Jean Christophe Bernhard, Fabien Bouliere, Jean De La Rosette, Alex Bex, Jerome Rigaud, Morgan Roupret, Guillaume Coffin, Jean Marie Ferriere, Jean Alexandre Long, Jean Louis Descotes, Alexander Zisman, Philippe Paparel, Charlotte Maurin, Eric Lechevallier, Roberto Bertini, Francesco Montorsi, Laurent Salomon, Roy Farfara, Bjorn Ljungberg, Alexandro Rodriguez, Karim Bensalah, and Jean Jacques Patard Gregory VerhoestGregory Verhoest Rennes, France More articles by this author , Thomas BessedeThomas Bessede Paris, France More articles by this author , Geraldine PignotGeraldine Pignot Paris, France More articles by this author , Rachid BahiRachid Bahi Paris, France More articles by this author , Jean Christophe BernhardJean Christophe Bernhard Bordeaux, France More articles by this author , Fabien BouliereFabien Bouliere Paris, France More articles by this author , Jean De La RosetteJean De La Rosette Amsterdam, Netherlands More articles by this author , Alex BexAlex Bex Amsterdam, Netherlands More articles by this author , Jerome RigaudJerome Rigaud Nantes, France More articles by this author , Morgan RoupretMorgan Roupret Paris, France More articles by this author , Guillaume CoffinGuillaume Coffin Paris, France More articles by this author , Jean Marie FerriereJean Marie Ferriere Bordeaux, France More articles by this author , Jean Alexandre LongJean Alexandre Long Grenoble, France More articles by this author , Jean Louis DescotesJean Louis Descotes Grenoble, France More articles by this author , Alexander ZismanAlexander Zisman Tel Aviv, Israel More articles by this author , Philippe PaparelPhilippe Paparel Lyon, France More articles by this author , Charlotte MaurinCharlotte Maurin Marseille, France More articles by this author , Eric LechevallierEric Lechevallier Marseille, France More articles by this author , Roberto BertiniRoberto Bertini Milan, Italy More articles by this author , Francesco MontorsiFrancesco Montorsi Milan, Italy More articles by this author , Laurent SalomonLaurent Salomon Paris, France More articles by this author , Roy FarfaraRoy Farfara Haifa, Israel More articles by this author , Bjorn LjungbergBjorn Ljungberg Umean, Sweden More articles by this author , Alexandro RodriguezAlexandro Rodriguez Tampa, FL More articles by this author , Karim BensalahKarim Bensalah Rennes, France More articles by this author , and Jean Jacques PatardJean Jacques Patard Paris, France More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.654AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multiple questions remain regarding surgical approach (laparoscopic vs open) or renal vessel clamping modalities for an optimal renal function preservation following partial nephrectomy (PN). Solitary kidney is indeed a good clinical model for analyzing functional consequences of PN. The objective of this study was to determine predictive factors for chronic renal failure following PN in the solitary kidney setting. METHODS Epidemiological variables, pre, per and post-operative parameters were extracted from 15 international centre partial nephrectomy databases. Information such as age, gender, BMI, Charlson index, tumor characteristics (tumor size, TNM stage), surgical parameters (renal clamping, ischemic time, renal cooling, surgery duration, operative blood loss), medical and surgical post-operative complications, MDRD glomerular filtration rates (GFR) before and after the surgery were registered. Multivariate analysis was performed by using a Cox regression model analysis. RESULTS 259 PN in solitary kidneys were analyzed. Patients were 164 (63.3%) men and 95 (36.7%) women whose median age was 62 years (29-84). Median tumor size was 3.5 cm (1-17). Median ischemic, opérative times and length of hospital stay were 16 min (0-160), 180 min (60-410) and 9 days (2-49). Median blood loss was 350 ml (0-4800). Temporary and permanent post-operative haemodialysis occurred in 16 (6.2%) and 8 (3.1%) patients respectively. Independent predictive factors for experiencing MDRD GFR <30 ml/min at last follow up were: BMI (p=0.007), Baseline renal function (p=0.0001), operative blood loss (p=0.001) and post operative medical complications (p=0.001). Ischemic time, renal vessels clamping modalities and renal cooling had no independent impact when all pre, per and post-operative parameters were included in the multivariate model. CONCLUSIONS Patient and renal function pre-operative characteristics as well as intra and post operative parameters are important predictive factors for chronic renal failure following partial nephrectomy in solitary kidneys. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e236 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gregory Verhoest Rennes, France More articles by this author Thomas Bessede Paris, France More articles by this author Geraldine Pignot Paris, France More articles by this author Rachid Bahi Paris, France More articles by this author Jean Christophe Bernhard Bordeaux, France More articles by this author Fabien Bouliere Paris, France More articles by this author Jean De La Rosette Amsterdam, Netherlands More articles by this author Alex Bex Amsterdam, Netherlands More articles by this author Jerome Rigaud Nantes, France More articles by this author Morgan Roupret Paris, France More articles by this author Guillaume Coffin Paris, France More articles by this author Jean Marie Ferriere Bordeaux, France More articles by this author Jean Alexandre Long Grenoble, France More articles by this author Jean Louis Descotes Grenoble, France More articles by this author Alexander Zisman Tel Aviv, Israel More articles by this author Philippe Paparel Lyon, France More articles by this author Charlotte Maurin Marseille, France More articles by this author Eric Lechevallier Marseille, France More articles by this author Roberto Bertini Milan, Italy More articles by this author Francesco Montorsi Milan, Italy More articles by this author Laurent Salomon Paris, France More articles by this author Roy Farfara Haifa, Israel More articles by this author Bjorn Ljungberg Umean, Sweden More articles by this author Alexandro Rodriguez Tampa, FL More articles by this author Karim Bensalah Rennes, France More articles by this author Jean Jacques Patard Paris, France More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...