628 PRE-OPERATIVE TOTAL RENAL VOLUME PREDICTS RISK OF CHRONIC KIDNEY DISEASE (CKD) AFTER RADICAL NEPHRECTOMY

You have accessJournal of UrologyKidney Cancer: Evaluation & Staging (I)1 Apr 2013628 PRE-OPERATIVE TOTAL RENAL VOLUME PREDICTS RISK OF CHRONIC KIDNEY DISEASE (CKD) AFTER RADICAL NEPHRECTOMY Fiona Wu, Melissa Tay, Bee Choo Tai, Zhao Jin Chen, Benjamin Goh, Lincoln Tan, Lata Raman, and Ho Yee Tiong Fiona WuFiona Wu Singapore, Singapore More articles by this author , Melissa TayMelissa Tay Singapore, Singapore More articles by this author , Bee Choo TaiBee Choo Tai Singapore, Singapore More articles by this author , Zhao Jin ChenZhao Jin Chen Singapore, Singapore More articles by this author , Benjamin GohBenjamin Goh Singapore, Singapore More articles by this author , Lincoln TanLincoln Tan Singapore, Singapore More articles by this author , Lata RamanLata Raman Singapore, Singapore More articles by this author , and Ho Yee TiongHo Yee Tiong Singapore, Singapore More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.180AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recent studies relate kidney volume with renal function. In this study, we measured pre-operative kidney volume for patients undergoing radical nephrectomy and studied its association with the risk of developing chronic kidney disease(CKD) after surgery. METHODS A retrospective review of 75 consecutive patients (29.3% females) with normal renal function (eGFR>60 ml/min/1.73 m2) who underwent radical nephrectomy (Sept 2000-Aug 2008) was performed. Each patientÆs CT scans was retrieved in ImageJ and bilateral kidney parenchyma and tumor were manually outlined in each transverse slice by a single surgeon. The area of normal kidney tissue segmented in each slice, excluding the tumor mass, renal vessels and central sinus fat, was multiplied by slice thickness to calculate volume. Estimated glomerular filtration rate (eGFR) was determined using the Modification of Diet in Renal Disease (MDRD) equation pre and post operatively during follow-up. CKD was defined as eGFR<60ml/min/1.73 m2. RESULTS Mean total kidney volume for this population (Mean age 55.4±12.5(SD)) was 246.3 ± 62.5cc. Pre operative eGFR was 84.3 ± 18.9 ml/min/1.73 m2. Over a median follow-up of 36 months, progression to CKD occurred in 42.6% (n=32) patients. Univariable logistic regression analysis showed that renal volume (p=0.01, HR 2.61 95%CI 1.25-5.43), age (p=0.002, HR 1.05 95%CI 1.02-1.09), male gender (p=0.02, HR 2.86 95%CI 1.18-7.14) and pre-operative GFR (p=0.002, HR 0.96 95%CI 0.93-0.98) were associated with post-operative CKD. The ROC area with pre-operative renal volume as a predictor of post-operative CKD was 0.65 (95% CI 0.53 to 0.78). Kaplan Meier analysis showed the median time to CKD after nephrectomy was 22.3 (0-87.6) months for renal volume less than 236cc (log rank p=0.008) but this was not achieved if renal volume is more than 236cc (Figure 1). CONCLUSIONS Total renal volume measured using ImageJ before radical nephrectomy is associated with development of post-operative CKD. In addition, a total pre-operative renal volume of less than 236 cc can be used as surrogate predictive marker of CKD development after radical nephrectomy. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e256-e257 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Fiona Wu Singapore, Singapore More articles by this author Melissa Tay Singapore, Singapore More articles by this author Bee Choo Tai Singapore, Singapore More articles by this author Zhao Jin Chen Singapore, Singapore More articles by this author Benjamin Goh Singapore, Singapore More articles by this author Lincoln Tan Singapore, Singapore More articles by this author Lata Raman Singapore, Singapore More articles by this author Ho Yee Tiong Singapore, Singapore More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...