The prediction of renal function 6 years after unilateral nephrectomy using preoperative risk factors.
OBJECTIVE
Since middle-aged and elderly patients seem to have risk factors affecting renal function, it is important to predict postoperative renal function prior to unilateral nephrectomy (UNx). We evaluated preoperative factors for predicting postoperative renal function in middle-aged and elderly patients with renal cell carcinoma (RCC) treated with radical nephrectomy (RNx).


METHODS
In 201 patients who underwent RNx preoperative records and postoperative serum creatinine (SCR) 6 years after nephrectomy were available. Postoperative renal insufficiency was defined as serum creatinine 1.4 mg/dl or greater. The relationship of each preoperative and postoperative factor was analyzed. Logistic regression analysis was performed to evaluate preoperative factors for predicting postoperative SCR 1.4 mg/dl or greater after 6 years.


RESULTS
There was a significant difference in postoperative SCR between female and male patients, and between those with and without hypertension, diabetes and proteinuria (p <0.05). Age, hemoglobin, preoperative SCR, blood urea nitrogen, uric acid and K significantly correlated with postoperative SCR (p <0.05). The increase in SCR during 6 years after UNx was significantly higher in patients with hypertension, diabetes and proteinuria than in their respective counterparts (p <0.05). Multivariate stepwise logistic regression analysis demonstrated that preoperative serum creatinine, hypertension and proteinuria were significant independent factors predicting postoperative renal function 6 years after UNx in patients with RCC (p <0.05).


CONCLUSIONS
Preoperative SCR, hypertension and proteinuria are useful factors for predicting postoperative renal function after RNx in patients with RCC.
Ito
Keiicho
K
Department of Urology, School of Medicine, Keio University, Tokyo, Japan. itok@me.ndmc.ac.jp
Nakashima
Jun
J
Hanawa
Yasumasa
Y
Oya
Mototsuga
M
Ohigashi
Takashi
T
Marumo
Ken
K
Murai
Masaru
M
D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007668:Kidney / Q000502:physiology*; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009392:Nephrectomy / Q000379:methods*; D011300:Preoperative Care; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors