Chronic kidney disease before and after partial nephrectomy

Melanie A. Clark, Sergey Shikanov, Jay Raman, Benjamin Smith, Matthew G. Kaag, Paul Russo, Jeffrey C. Wheat, J. Stuart Wolf, Surena F. Matin, William C. Huang, Arieh L. Shalhav, Scott E. Eggener

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

Purpose We performed a multi-institutional retrospective cohort study to evaluate baseline renal function of patients who underwent partial nephrectomy for renal tumors, and determined rates of progression to higher stages of chronic kidney disease. Materials and Methods The Modification of Diet in Renal Disease study equation was used to estimate glomerular filtration rate. Preoperative and postoperative serum creatinine values were obtained from patients who underwent partial nephrectomy at 6 institutions with a normal contralateral kidney, and had baseline chronic kidney disease stage I (estimated glomerular filtration rate greater than 90 ml/minute/1.73 m2), II (estimated glomerular filtration rate 60 to 89 ml/minute/1.73 m2) or III (estimated glomerular filtration rate 30 to 59 ml/minute/1.73 m 2). The end point was change in chronic kidney disease stage at long-term followup (3 to 18 months). Multivariate logistic and Cox regression models tested the association of newly acquired chronic kidney disease stage III or greater with pertinent demographic, tumor and surgical factors. Results For 1,228 patients with followup creatinine data at least 3 months after partial nephrectomy median baseline glomerular filtration rate was 74 ml/minute/1.73 m2. At baseline 19%, 59% and 22% of patients had chronic kidney disease stage I, II and III, respectively. At long-term followup for patients with baseline chronic kidney disease stage I or II median postoperative glomerular filtration rate was 67 ml/minute/1.73 m2 with 29% having progression to chronic kidney disease stage III or greater. Increasing age, female gender, increasing tumor size, clamping of the renal artery and vein, and lower preoperative estimated glomerular filtration rate were independently associated with newly acquired chronic kidney disease stage III or greater. The presence of comorbid conditions such as coronary artery disease, diabetes mellitus or hypertension did not independently predict an increased risk of higher chronic kidney disease stage. Conclusions Chronic kidney disease stage III or greater will develop postoperatively in approximately a third of patients with an estimated glomerular filtration rate greater than 60 ml/minute/1.73 m2, and this progression is associated with definable demographic, tumor and surgical factors.

Original languageEnglish (US)
Pages (from-to)43-48
Number of pages6
JournalJournal of Urology
Volume185
Issue number1
DOIs
StatePublished - Jan 1 2011

Fingerprint

Nephrectomy
Chronic Renal Insufficiency
Glomerular Filtration Rate
Kidney
Creatinine
Neoplasms
Demography
Diet Therapy
Renal Veins
Renal Artery
Proportional Hazards Models
Constriction
Coronary Artery Disease
Diabetes Mellitus
Cohort Studies
Retrospective Studies
Logistic Models
Hypertension

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Clark, M. A., Shikanov, S., Raman, J., Smith, B., Kaag, M. G., Russo, P., ... Eggener, S. E. (2011). Chronic kidney disease before and after partial nephrectomy. Journal of Urology, 185(1), 43-48. https://doi.org/10.1016/j.juro.2010.09.019
Clark, Melanie A. ; Shikanov, Sergey ; Raman, Jay ; Smith, Benjamin ; Kaag, Matthew G. ; Russo, Paul ; Wheat, Jeffrey C. ; Wolf, J. Stuart ; Matin, Surena F. ; Huang, William C. ; Shalhav, Arieh L. ; Eggener, Scott E. / Chronic kidney disease before and after partial nephrectomy. In: Journal of Urology. 2011 ; Vol. 185, No. 1. pp. 43-48.
@article{d4d20d128caa4c5e954e5db9c39cdd48,
title = "Chronic kidney disease before and after partial nephrectomy",
abstract = "Purpose We performed a multi-institutional retrospective cohort study to evaluate baseline renal function of patients who underwent partial nephrectomy for renal tumors, and determined rates of progression to higher stages of chronic kidney disease. Materials and Methods The Modification of Diet in Renal Disease study equation was used to estimate glomerular filtration rate. Preoperative and postoperative serum creatinine values were obtained from patients who underwent partial nephrectomy at 6 institutions with a normal contralateral kidney, and had baseline chronic kidney disease stage I (estimated glomerular filtration rate greater than 90 ml/minute/1.73 m2), II (estimated glomerular filtration rate 60 to 89 ml/minute/1.73 m2) or III (estimated glomerular filtration rate 30 to 59 ml/minute/1.73 m 2). The end point was change in chronic kidney disease stage at long-term followup (3 to 18 months). Multivariate logistic and Cox regression models tested the association of newly acquired chronic kidney disease stage III or greater with pertinent demographic, tumor and surgical factors. Results For 1,228 patients with followup creatinine data at least 3 months after partial nephrectomy median baseline glomerular filtration rate was 74 ml/minute/1.73 m2. At baseline 19{\%}, 59{\%} and 22{\%} of patients had chronic kidney disease stage I, II and III, respectively. At long-term followup for patients with baseline chronic kidney disease stage I or II median postoperative glomerular filtration rate was 67 ml/minute/1.73 m2 with 29{\%} having progression to chronic kidney disease stage III or greater. Increasing age, female gender, increasing tumor size, clamping of the renal artery and vein, and lower preoperative estimated glomerular filtration rate were independently associated with newly acquired chronic kidney disease stage III or greater. The presence of comorbid conditions such as coronary artery disease, diabetes mellitus or hypertension did not independently predict an increased risk of higher chronic kidney disease stage. Conclusions Chronic kidney disease stage III or greater will develop postoperatively in approximately a third of patients with an estimated glomerular filtration rate greater than 60 ml/minute/1.73 m2, and this progression is associated with definable demographic, tumor and surgical factors.",
author = "Clark, {Melanie A.} and Sergey Shikanov and Jay Raman and Benjamin Smith and Kaag, {Matthew G.} and Paul Russo and Wheat, {Jeffrey C.} and Wolf, {J. Stuart} and Matin, {Surena F.} and Huang, {William C.} and Shalhav, {Arieh L.} and Eggener, {Scott E.}",
year = "2011",
month = "1",
day = "1",
doi = "10.1016/j.juro.2010.09.019",
language = "English (US)",
volume = "185",
pages = "43--48",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "1",

}

Clark, MA, Shikanov, S, Raman, J, Smith, B, Kaag, MG, Russo, P, Wheat, JC, Wolf, JS, Matin, SF, Huang, WC, Shalhav, AL & Eggener, SE 2011, 'Chronic kidney disease before and after partial nephrectomy', Journal of Urology, vol. 185, no. 1, pp. 43-48. https://doi.org/10.1016/j.juro.2010.09.019

Chronic kidney disease before and after partial nephrectomy. / Clark, Melanie A.; Shikanov, Sergey; Raman, Jay; Smith, Benjamin; Kaag, Matthew G.; Russo, Paul; Wheat, Jeffrey C.; Wolf, J. Stuart; Matin, Surena F.; Huang, William C.; Shalhav, Arieh L.; Eggener, Scott E.

In: Journal of Urology, Vol. 185, No. 1, 01.01.2011, p. 43-48.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Chronic kidney disease before and after partial nephrectomy

AU - Clark, Melanie A.

AU - Shikanov, Sergey

AU - Raman, Jay

AU - Smith, Benjamin

AU - Kaag, Matthew G.

AU - Russo, Paul

AU - Wheat, Jeffrey C.

AU - Wolf, J. Stuart

AU - Matin, Surena F.

AU - Huang, William C.

AU - Shalhav, Arieh L.

AU - Eggener, Scott E.

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Purpose We performed a multi-institutional retrospective cohort study to evaluate baseline renal function of patients who underwent partial nephrectomy for renal tumors, and determined rates of progression to higher stages of chronic kidney disease. Materials and Methods The Modification of Diet in Renal Disease study equation was used to estimate glomerular filtration rate. Preoperative and postoperative serum creatinine values were obtained from patients who underwent partial nephrectomy at 6 institutions with a normal contralateral kidney, and had baseline chronic kidney disease stage I (estimated glomerular filtration rate greater than 90 ml/minute/1.73 m2), II (estimated glomerular filtration rate 60 to 89 ml/minute/1.73 m2) or III (estimated glomerular filtration rate 30 to 59 ml/minute/1.73 m 2). The end point was change in chronic kidney disease stage at long-term followup (3 to 18 months). Multivariate logistic and Cox regression models tested the association of newly acquired chronic kidney disease stage III or greater with pertinent demographic, tumor and surgical factors. Results For 1,228 patients with followup creatinine data at least 3 months after partial nephrectomy median baseline glomerular filtration rate was 74 ml/minute/1.73 m2. At baseline 19%, 59% and 22% of patients had chronic kidney disease stage I, II and III, respectively. At long-term followup for patients with baseline chronic kidney disease stage I or II median postoperative glomerular filtration rate was 67 ml/minute/1.73 m2 with 29% having progression to chronic kidney disease stage III or greater. Increasing age, female gender, increasing tumor size, clamping of the renal artery and vein, and lower preoperative estimated glomerular filtration rate were independently associated with newly acquired chronic kidney disease stage III or greater. The presence of comorbid conditions such as coronary artery disease, diabetes mellitus or hypertension did not independently predict an increased risk of higher chronic kidney disease stage. Conclusions Chronic kidney disease stage III or greater will develop postoperatively in approximately a third of patients with an estimated glomerular filtration rate greater than 60 ml/minute/1.73 m2, and this progression is associated with definable demographic, tumor and surgical factors.

AB - Purpose We performed a multi-institutional retrospective cohort study to evaluate baseline renal function of patients who underwent partial nephrectomy for renal tumors, and determined rates of progression to higher stages of chronic kidney disease. Materials and Methods The Modification of Diet in Renal Disease study equation was used to estimate glomerular filtration rate. Preoperative and postoperative serum creatinine values were obtained from patients who underwent partial nephrectomy at 6 institutions with a normal contralateral kidney, and had baseline chronic kidney disease stage I (estimated glomerular filtration rate greater than 90 ml/minute/1.73 m2), II (estimated glomerular filtration rate 60 to 89 ml/minute/1.73 m2) or III (estimated glomerular filtration rate 30 to 59 ml/minute/1.73 m 2). The end point was change in chronic kidney disease stage at long-term followup (3 to 18 months). Multivariate logistic and Cox regression models tested the association of newly acquired chronic kidney disease stage III or greater with pertinent demographic, tumor and surgical factors. Results For 1,228 patients with followup creatinine data at least 3 months after partial nephrectomy median baseline glomerular filtration rate was 74 ml/minute/1.73 m2. At baseline 19%, 59% and 22% of patients had chronic kidney disease stage I, II and III, respectively. At long-term followup for patients with baseline chronic kidney disease stage I or II median postoperative glomerular filtration rate was 67 ml/minute/1.73 m2 with 29% having progression to chronic kidney disease stage III or greater. Increasing age, female gender, increasing tumor size, clamping of the renal artery and vein, and lower preoperative estimated glomerular filtration rate were independently associated with newly acquired chronic kidney disease stage III or greater. The presence of comorbid conditions such as coronary artery disease, diabetes mellitus or hypertension did not independently predict an increased risk of higher chronic kidney disease stage. Conclusions Chronic kidney disease stage III or greater will develop postoperatively in approximately a third of patients with an estimated glomerular filtration rate greater than 60 ml/minute/1.73 m2, and this progression is associated with definable demographic, tumor and surgical factors.

UR - http://www.scopus.com/inward/record.url?scp=78649986915&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78649986915&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2010.09.019

DO - 10.1016/j.juro.2010.09.019

M3 - Article

C2 - 21074205

AN - SCOPUS:78649986915

VL - 185

SP - 43

EP - 48

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 1

ER -