title: Causes of diminished renal function in the affected kidney after partial nephrectomy.
abstract: OBJECTIVE
  To determine the cause of diminished renal function in the affected kidney after partial nephrectomy (PN) for renal tumour, we analyzed the relationship between operative data and postoperative recovery with respect to renal function.
  
  
  METHODS
  From May 2005 to December 2010, pre- and postoperative (1 week and 3 months after the procedure) renal function was evaluated by 99mTc- mercaptoacetyltriglycine clearance in 51 patients treated with open partial nephrectomy (OPN; n = 24) and laparoscopic partial nephrectomy (LPN; n = 27). LPN was performed via retroperitoneal (RPLPN; n = 14) or transperitoneal (TPLPN; n = 13) routes. Renal cooling was performed after renal hilar clamping in OPN and RPLPN, although not in TPLPN.
  
  
  RESULTS
  There were 10 patients (two in OPN, six in TPLPN, two in RPLPN) who had diminished renal function in the affected kidney from 1 week to 3 months after PN. Warm ischaemia (versus cold ischaemia; P = 0.017) during renal hilar clamping resulted in diminished renal function. Using multivariate analysis, renal cooling influenced postoperative diminished renal function (P = 0.008).
  
  
  CONCLUSIONS
  Successful preservation of renal function after PN depends on renal cooling during renal hilar clamping. Cold ischaemia for avoiding renal damage is recommended if renal hilar clamping is necessary for tumour extraction.
authors.affiliation: Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. ktatsu@uro.med.kyushu-u.ac.jp
authors.forename: Katsunori
authors.initials: K
authors.lastname: Tatsugami
authors.forename: Shingo
authors.initials: S
authors.lastname: Tanaka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ohtsubo
authors.forename: Junichi
authors.initials: J
authors.lastname: Inokuchi
authors.forename: Akira
authors.initials: A
authors.lastname: Yokomizo
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kuroiwa
authors.forename: Yoo Hyun
authors.initials: YH
authors.lastname: Song
authors.forename: Seiji
authors.initials: S
authors.lastname: Naito
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology*; D007677:Kidney Function Tests; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide
chemical_list: D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide