Compensatory structural and functional adaptation after radical nephrectomy for renal cell carcinoma according to preoperative stage of chronic kidney disease. Choi DK, Jung SB, Park BH, Jeong BC, Seo SI, Jeon SS, Lee HM, Choi HY, Jeon HG.J Urol. 2015 Oct;194(4):910-5. [Epub 2015 Apr 28]. doi: 10.1016/j.juro.2015.04.093.

Jay Raman, S. B. Jung, B. H. Park, B. C. Jeong, S. I. Seo, S. S. Jeon, H. M. Lee, H. Y. Choi, H. G. Jeon

Research output: Contribution to journalShort survey

Abstract

Purpose We investigated structural hypertrophy and functional hyperfiltration as compensatory adaptations after radical nephrectomy in patients with renal cell carcinoma according to the preoperative chronic kidney disease stage. Materials and methods We retrospectively identified 543 patients who underwent radical nephrectomy for renal cell carcinoma between 1997 and 2012. Patients were classified according to preoperative glomerular filtration rate as no chronic kidney disease—glomerular filtration rate 90 ml/min/1.73 m 2 or greater (230, 42.4%), chronic kidney disease stage II—glomerular filtration rate 60 to less than 90 ml/min/1.73 m 2 (227, 41.8%), and chronic kidney disease stage III—glomerular filtration rate 30 to less than 60 ml/min/1.73 m 2 (86, 15.8%). Computerized tomography performed within 2 months before surgery and 1 year after surgery was used to assess functional renal volume for measuring the degree of hypertrophy of the remnant kidney, and the preoperative and postoperative glomerular filtration rate per unit volume of functional renal volume was used to calculate the degree of hyperfiltration. Results Among all patients (mean age = 56.0 y) mean preoperative glomerular filtration rate, functional renal volume, and glomerular filtration rate/functional renal volume were 83.2 ml/min/1.73 m 2 , 340.6 cm 3 , and 0.25 ml/min/1.73 m 2 /cm 3 , respectively. The percent reduction in glomerular filtration rate was statistically significant according to chronic kidney disease stage (no chronic kidney disease 31.2% vs. stage II 26.5% vs. stage III 12.8%, P<0.001). However, the degree of hypertrophic functional renal volume in the remnant kidney was not statistically significant (no chronic kidney disease 18.5% vs. stage II 17.3% vs. stage III 16.5%, P = 0.250). The change in glomerular filtration rate/functional renal volume was statistically significant (no chronic kidney disease 18.5% vs. stage II 20.1% vs. stage III 45.9%, P<0.001). Factors that increased glomerular filtration rate/functional renal volume above the mean value were body mass index (P = 0.012), diabetes mellitus (P = 0.023), hypertension (P = 0.015), and chronic kidney disease stage (P<0.001). Conclusions Patients with a lower preoperative glomerular filtration rate had a smaller reduction in postoperative renal function than those with a higher preoperative glomerular filtration rate due to greater degrees of functional hyperfiltration.

Original languageEnglish (US)
Pages (from-to)118-119
Number of pages2
JournalUrologic Oncology: Seminars and Original Investigations
Volume35
Issue number3
DOIs
StatePublished - Mar 1 2017

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Nephrectomy
Chronic Renal Insufficiency
Renal Cell Carcinoma
Glomerular Filtration Rate
Kidney
Hypertrophy
Diabetes Mellitus
Body Mass Index
Tomography
Hypertension

All Science Journal Classification (ASJC) codes

  • Oncology
  • Urology

Cite this

@article{32cc1b891ff64fa78efcb79c0884ebdd,
title = "Compensatory structural and functional adaptation after radical nephrectomy for renal cell carcinoma according to preoperative stage of chronic kidney disease. Choi DK, Jung SB, Park BH, Jeong BC, Seo SI, Jeon SS, Lee HM, Choi HY, Jeon HG.J Urol. 2015 Oct;194(4):910-5. [Epub 2015 Apr 28]. doi: 10.1016/j.juro.2015.04.093.",
abstract = "Purpose We investigated structural hypertrophy and functional hyperfiltration as compensatory adaptations after radical nephrectomy in patients with renal cell carcinoma according to the preoperative chronic kidney disease stage. Materials and methods We retrospectively identified 543 patients who underwent radical nephrectomy for renal cell carcinoma between 1997 and 2012. Patients were classified according to preoperative glomerular filtration rate as no chronic kidney disease—glomerular filtration rate 90 ml/min/1.73 m 2 or greater (230, 42.4{\%}), chronic kidney disease stage II—glomerular filtration rate 60 to less than 90 ml/min/1.73 m 2 (227, 41.8{\%}), and chronic kidney disease stage III—glomerular filtration rate 30 to less than 60 ml/min/1.73 m 2 (86, 15.8{\%}). Computerized tomography performed within 2 months before surgery and 1 year after surgery was used to assess functional renal volume for measuring the degree of hypertrophy of the remnant kidney, and the preoperative and postoperative glomerular filtration rate per unit volume of functional renal volume was used to calculate the degree of hyperfiltration. Results Among all patients (mean age = 56.0 y) mean preoperative glomerular filtration rate, functional renal volume, and glomerular filtration rate/functional renal volume were 83.2 ml/min/1.73 m 2 , 340.6 cm 3 , and 0.25 ml/min/1.73 m 2 /cm 3 , respectively. The percent reduction in glomerular filtration rate was statistically significant according to chronic kidney disease stage (no chronic kidney disease 31.2{\%} vs. stage II 26.5{\%} vs. stage III 12.8{\%}, P<0.001). However, the degree of hypertrophic functional renal volume in the remnant kidney was not statistically significant (no chronic kidney disease 18.5{\%} vs. stage II 17.3{\%} vs. stage III 16.5{\%}, P = 0.250). The change in glomerular filtration rate/functional renal volume was statistically significant (no chronic kidney disease 18.5{\%} vs. stage II 20.1{\%} vs. stage III 45.9{\%}, P<0.001). Factors that increased glomerular filtration rate/functional renal volume above the mean value were body mass index (P = 0.012), diabetes mellitus (P = 0.023), hypertension (P = 0.015), and chronic kidney disease stage (P<0.001). Conclusions Patients with a lower preoperative glomerular filtration rate had a smaller reduction in postoperative renal function than those with a higher preoperative glomerular filtration rate due to greater degrees of functional hyperfiltration.",
author = "Jay Raman and Jung, {S. B.} and Park, {B. H.} and Jeong, {B. C.} and Seo, {S. I.} and Jeon, {S. S.} and Lee, {H. M.} and Choi, {H. Y.} and Jeon, {H. G.}",
year = "2017",
month = "3",
day = "1",
doi = "10.1016/j.urolonc.2016.12.024",
language = "English (US)",
volume = "35",
pages = "118--119",
journal = "Urologic Oncology",
issn = "1078-1439",
publisher = "Elsevier Inc.",
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TY - JOUR

T1 - Compensatory structural and functional adaptation after radical nephrectomy for renal cell carcinoma according to preoperative stage of chronic kidney disease. Choi DK, Jung SB, Park BH, Jeong BC, Seo SI, Jeon SS, Lee HM, Choi HY, Jeon HG.J Urol. 2015 Oct;194(4):910-5. [Epub 2015 Apr 28]. doi

T2 - 10.1016/j.juro.2015.04.093.

AU - Raman, Jay

AU - Jung, S. B.

AU - Park, B. H.

AU - Jeong, B. C.

AU - Seo, S. I.

AU - Jeon, S. S.

AU - Lee, H. M.

AU - Choi, H. Y.

AU - Jeon, H. G.

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Purpose We investigated structural hypertrophy and functional hyperfiltration as compensatory adaptations after radical nephrectomy in patients with renal cell carcinoma according to the preoperative chronic kidney disease stage. Materials and methods We retrospectively identified 543 patients who underwent radical nephrectomy for renal cell carcinoma between 1997 and 2012. Patients were classified according to preoperative glomerular filtration rate as no chronic kidney disease—glomerular filtration rate 90 ml/min/1.73 m 2 or greater (230, 42.4%), chronic kidney disease stage II—glomerular filtration rate 60 to less than 90 ml/min/1.73 m 2 (227, 41.8%), and chronic kidney disease stage III—glomerular filtration rate 30 to less than 60 ml/min/1.73 m 2 (86, 15.8%). Computerized tomography performed within 2 months before surgery and 1 year after surgery was used to assess functional renal volume for measuring the degree of hypertrophy of the remnant kidney, and the preoperative and postoperative glomerular filtration rate per unit volume of functional renal volume was used to calculate the degree of hyperfiltration. Results Among all patients (mean age = 56.0 y) mean preoperative glomerular filtration rate, functional renal volume, and glomerular filtration rate/functional renal volume were 83.2 ml/min/1.73 m 2 , 340.6 cm 3 , and 0.25 ml/min/1.73 m 2 /cm 3 , respectively. The percent reduction in glomerular filtration rate was statistically significant according to chronic kidney disease stage (no chronic kidney disease 31.2% vs. stage II 26.5% vs. stage III 12.8%, P<0.001). However, the degree of hypertrophic functional renal volume in the remnant kidney was not statistically significant (no chronic kidney disease 18.5% vs. stage II 17.3% vs. stage III 16.5%, P = 0.250). The change in glomerular filtration rate/functional renal volume was statistically significant (no chronic kidney disease 18.5% vs. stage II 20.1% vs. stage III 45.9%, P<0.001). Factors that increased glomerular filtration rate/functional renal volume above the mean value were body mass index (P = 0.012), diabetes mellitus (P = 0.023), hypertension (P = 0.015), and chronic kidney disease stage (P<0.001). Conclusions Patients with a lower preoperative glomerular filtration rate had a smaller reduction in postoperative renal function than those with a higher preoperative glomerular filtration rate due to greater degrees of functional hyperfiltration.

AB - Purpose We investigated structural hypertrophy and functional hyperfiltration as compensatory adaptations after radical nephrectomy in patients with renal cell carcinoma according to the preoperative chronic kidney disease stage. Materials and methods We retrospectively identified 543 patients who underwent radical nephrectomy for renal cell carcinoma between 1997 and 2012. Patients were classified according to preoperative glomerular filtration rate as no chronic kidney disease—glomerular filtration rate 90 ml/min/1.73 m 2 or greater (230, 42.4%), chronic kidney disease stage II—glomerular filtration rate 60 to less than 90 ml/min/1.73 m 2 (227, 41.8%), and chronic kidney disease stage III—glomerular filtration rate 30 to less than 60 ml/min/1.73 m 2 (86, 15.8%). Computerized tomography performed within 2 months before surgery and 1 year after surgery was used to assess functional renal volume for measuring the degree of hypertrophy of the remnant kidney, and the preoperative and postoperative glomerular filtration rate per unit volume of functional renal volume was used to calculate the degree of hyperfiltration. Results Among all patients (mean age = 56.0 y) mean preoperative glomerular filtration rate, functional renal volume, and glomerular filtration rate/functional renal volume were 83.2 ml/min/1.73 m 2 , 340.6 cm 3 , and 0.25 ml/min/1.73 m 2 /cm 3 , respectively. The percent reduction in glomerular filtration rate was statistically significant according to chronic kidney disease stage (no chronic kidney disease 31.2% vs. stage II 26.5% vs. stage III 12.8%, P<0.001). However, the degree of hypertrophic functional renal volume in the remnant kidney was not statistically significant (no chronic kidney disease 18.5% vs. stage II 17.3% vs. stage III 16.5%, P = 0.250). The change in glomerular filtration rate/functional renal volume was statistically significant (no chronic kidney disease 18.5% vs. stage II 20.1% vs. stage III 45.9%, P<0.001). Factors that increased glomerular filtration rate/functional renal volume above the mean value were body mass index (P = 0.012), diabetes mellitus (P = 0.023), hypertension (P = 0.015), and chronic kidney disease stage (P<0.001). Conclusions Patients with a lower preoperative glomerular filtration rate had a smaller reduction in postoperative renal function than those with a higher preoperative glomerular filtration rate due to greater degrees of functional hyperfiltration.

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U2 - 10.1016/j.urolonc.2016.12.024

DO - 10.1016/j.urolonc.2016.12.024

M3 - Short survey

C2 - 28159494

AN - SCOPUS:85011019601

VL - 35

SP - 118

EP - 119

JO - Urologic Oncology

JF - Urologic Oncology

SN - 1078-1439

IS - 3

ER -