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Renal function after nephron-sparing surgery for renal tumors.

Sosnowski R, Benke M, Demkow T, Ligaj M, Michalski W - Cent European J Urol (2012)

Bottom Line: In 12 patients (60%) no change was observed.The relative percentage GFR-share of operated kidney decreased by the average value of 3.8% (p >0.005).Multifactorial analysis did not identify significant effect of potential risk factors on the function of the kidney subjected to NSS.

View Article: PubMed Central - PubMed

Affiliation: Urooncology Department, Maria Skłodowska-Curie, Memorial Cancer Hospital, Warsaw, Poland.

ABSTRACT
Nephron sparing surgery (NSS) is a technique more frequently utilized in the case of surgical treatment of kidney tumor. The aim of the study is to assess renal function in patients treated with NSS for renal tumors. Twenty patients, after NSS performed for renal tumor, were included in the study. In each patient dynamic renal scintigraphy was performed before surgical treatment (test No. 1) and after a mean interval of 12 months after surgical procedure (test No. 2). In each test renographic curves were evaluated. Creatinine levels and GFR rates were also assessed. Mean GFR was 84 ml/min/1.73 m(2) before surgery, and 79 ml/min/1.73 m(2) after surgical procedure. Mean change of GFR value after the surgical procedure was -5.1 (p >0.058). On renography significant deterioration of renal function was observed in the operated kidneys of 4 patients (20%) after NSS, insignificant deterioration - in four patients (20%) and improvement of renal function of operated kidney was found in one patient. In 12 patients (60%) no change was observed. The relative percentage GFR-share of operated kidney decreased by the average value of 3.8% (p >0.005). Multifactorial analysis did not identify significant effect of potential risk factors on the function of the kidney subjected to NSS. Preliminary results of this study confirm that deterioration of renal function after NSS is a rare event.

No MeSH data available.


Related in: MedlinePlus

Difference of the relative percentage share of operated kidney.
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Figure 0002: Difference of the relative percentage share of operated kidney.

Mentions: Mean GFR before surgery (test No. 1) was 84 ml/min/1.73 m2. Mean GFR after NSS (test no 2) was 79 ml/min/1.73 m2. Mean change of GFR value after the surgical treatment was – 5.1 (p >0.058). Mean serum creatinine before NSS was 0.91 (range 0.6-2.45). Mean postoperative serum creatinine was 1.08 (range 0.8-2.58). In one patient severe deterioration of kidney function appeared secondary to chronic renal cirrhosis (contralateral kidney with no tumor) (pre-NSS creatinine – 0.9, post-NSS – 2.45). Significant statistical difference was observed between the levels of serum creatinine before and after NSS (p <0.001). Comparison of renography results (test no. 1 vs. test no. 2) identified 4 patients (20%) with significant deterioration of renal function after NSS (GFR decrease by a mean value of 17.1 and switch in the renographic curve type: from type 1 or 2 to type 4). No cases of kidney failure were diagnosed after NSS as specified by KDOQI criteria [9]. Insignificant deterioration of function of operated kidney was observed in four patients (20%) and improvement of renal function of operated kidney was found in one patient. Renal function after NSS in the remaining 12 patients (60%) remained unchanged after NSS. The relative percentage share of operated kidney decreased by a mean value of 3.8% (p >0.005) (Fig. 2). The following risk factors potentially affecting kidney function were identified in patients’ medical history: nicotinism – in 2 patients, hypertension – 9 patients, diabetes – 1 patient, and prior chemotherapy – 1 patient. Due to a relatively small study group statistical analysis of potential influence of risk factors on kidney function was not possible.


Renal function after nephron-sparing surgery for renal tumors.

Sosnowski R, Benke M, Demkow T, Ligaj M, Michalski W - Cent European J Urol (2012)

Difference of the relative percentage share of operated kidney.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921763&req=5

Figure 0002: Difference of the relative percentage share of operated kidney.
Mentions: Mean GFR before surgery (test No. 1) was 84 ml/min/1.73 m2. Mean GFR after NSS (test no 2) was 79 ml/min/1.73 m2. Mean change of GFR value after the surgical treatment was – 5.1 (p >0.058). Mean serum creatinine before NSS was 0.91 (range 0.6-2.45). Mean postoperative serum creatinine was 1.08 (range 0.8-2.58). In one patient severe deterioration of kidney function appeared secondary to chronic renal cirrhosis (contralateral kidney with no tumor) (pre-NSS creatinine – 0.9, post-NSS – 2.45). Significant statistical difference was observed between the levels of serum creatinine before and after NSS (p <0.001). Comparison of renography results (test no. 1 vs. test no. 2) identified 4 patients (20%) with significant deterioration of renal function after NSS (GFR decrease by a mean value of 17.1 and switch in the renographic curve type: from type 1 or 2 to type 4). No cases of kidney failure were diagnosed after NSS as specified by KDOQI criteria [9]. Insignificant deterioration of function of operated kidney was observed in four patients (20%) and improvement of renal function of operated kidney was found in one patient. Renal function after NSS in the remaining 12 patients (60%) remained unchanged after NSS. The relative percentage share of operated kidney decreased by a mean value of 3.8% (p >0.005) (Fig. 2). The following risk factors potentially affecting kidney function were identified in patients’ medical history: nicotinism – in 2 patients, hypertension – 9 patients, diabetes – 1 patient, and prior chemotherapy – 1 patient. Due to a relatively small study group statistical analysis of potential influence of risk factors on kidney function was not possible.

Bottom Line: In 12 patients (60%) no change was observed.The relative percentage GFR-share of operated kidney decreased by the average value of 3.8% (p >0.005).Multifactorial analysis did not identify significant effect of potential risk factors on the function of the kidney subjected to NSS.

View Article: PubMed Central - PubMed

Affiliation: Urooncology Department, Maria Skłodowska-Curie, Memorial Cancer Hospital, Warsaw, Poland.

ABSTRACT
Nephron sparing surgery (NSS) is a technique more frequently utilized in the case of surgical treatment of kidney tumor. The aim of the study is to assess renal function in patients treated with NSS for renal tumors. Twenty patients, after NSS performed for renal tumor, were included in the study. In each patient dynamic renal scintigraphy was performed before surgical treatment (test No. 1) and after a mean interval of 12 months after surgical procedure (test No. 2). In each test renographic curves were evaluated. Creatinine levels and GFR rates were also assessed. Mean GFR was 84 ml/min/1.73 m(2) before surgery, and 79 ml/min/1.73 m(2) after surgical procedure. Mean change of GFR value after the surgical procedure was -5.1 (p >0.058). On renography significant deterioration of renal function was observed in the operated kidneys of 4 patients (20%) after NSS, insignificant deterioration - in four patients (20%) and improvement of renal function of operated kidney was found in one patient. In 12 patients (60%) no change was observed. The relative percentage GFR-share of operated kidney decreased by the average value of 3.8% (p >0.005). Multifactorial analysis did not identify significant effect of potential risk factors on the function of the kidney subjected to NSS. Preliminary results of this study confirm that deterioration of renal function after NSS is a rare event.

No MeSH data available.


Related in: MedlinePlus