title: Intra-operative erythropoietin during laparoscopic partial nephrectomy is not renoprotective.
abstract: OBJECTIVE
  In pre-clinical studies, acute erythropoietin (EPO) administration has been shown to mitigate the deleterious effects of ischemia/reperfusion injury. We reviewed our clinical experience with intraoperative EPO administration as a potential renoprotective agent during laparoscopic partial nephrectomy (LPN).
  
  
  METHODS
  Patients who underwent LPN at our institution between August 2008 and March 2010 received 500 IU/kg EPO 30 min prior to hilar occlusion. Those who underwent LPN between August 2006 and July 2008 without receiving EPO were selected as controls. Demographic, clinical, perioperative, and estimated glomerular filtration rate (eGFR) data were compared for the cohorts preoperatively, and during short-term (<6 months) and long-term (≥6 months) follow-up.
  
  
  RESULTS
  Short-term eGFR was evaluable for 39 EPO and 29 controls, while long-term eGFR was evaluable for 26 EPO and 27 controls. Baseline demographic and clinical features of the cohorts were similar. For EPO versus controls, median short and long-term follow-up was 19 days versus 22 days and 10.2 months versus 11.9 months, respectively. Mean preoperative, postoperative, and % change in eGFR were statistically similar for the cohorts during short- and long-term follow-up, without and with adjustment for baseline renal function (unadjusted P-values = 0.28, 0.095, and 0.38, respectively, short term, and 0.61, 0.50, and 0.69, respectively, long term).
  
  
  CONCLUSIONS
  In this retrospective study, a single dose of EPO prior to hilar occlusion during LPN had no added protective impact on postoperative eGFR in the short or long term. Prospective evaluation in patients with solitary kidneys may better elucidate its potential renoprotective role in this setting.
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, USA.
authors.forename: Ephrem O
authors.initials: EO
authors.lastname: Olweny
authors.forename: Saad A
authors.initials: SA
authors.lastname: Mir
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Park
authors.forename: Yung K
authors.initials: YK
authors.lastname: Tan
authors.forename: Stephen
authors.initials: S
authors.lastname: Faddegon
authors.forename: Sara L
authors.initials: SL
authors.lastname: Best
authors.forename: Cenk
authors.initials: C
authors.lastname: Gurbuz
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cadeddu
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007432:Intraoperative Period; D007668:Kidney / Q000502:physiology / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009392:Nephrectomy / Q000379:methods*; D011184:Postoperative Period; D051436:Renal Insufficiency, Chronic / Q000601:surgery*; D015427:Reperfusion Injury / Q000517:prevention & control*; D012189:Retrospective Studies; D016896:Treatment Outcome; D052096:Warm Ischemia
chemical_list: D004921:Erythropoietin; D003404:Creatinine