title: Can we predict which patients will evolve to chronic kidney disease after nephrectomy for cortical renal tumors?
abstract: BACKGROUND
  While some studies show that patients submitted to radical nephrectomy have a higher risk of developing chronic kidney disease (CKD), some studies report that carefully selected living kidney donors do not present a higher risk for CKD. Here, we aim to study predictive factors of CKD after radical nephrectomy.
  
  
  METHODS
  Between January 2006 to January 2010, 107 patients submitted to radical nephrectomy for cortical renal tumors at our institution were enrolled in this study. Demographic data were recorded, modified Charlson-Romano Index was calculated, and creatinine clearance was estimated using abbreviated Modification of Diet in Renal Disease (MDRD) study equation. Pathological characteristics, surgical access and surgical complications were also reviewed. The end-point of the current study was new onset estimated glomerular filtration rate (eGFR) less than 60 and less than 45 mL/minute/1.73 m(2).
  
  
  RESULTS
  Age, preoperative eGFR, Charlson-Romano Index and hypertension were predictive factors of renal function loss, when the end-point considered was eGFR lower than 60 mL/minute/1.73 m(2). Age and preoperative eGFR were predictive factors of renal function loss, when the end-point considered was eGFR lower than 45 mL/minute/ 1.73 m(2). Moreover, each year older increased 1.1 times the risk of eGFR lower than 60 and 45 mL/minute/1.73 m(2). After multivariate logistic regression, only age remained as an independent predictive factor of eGFR loss.
  
  
  CONCLUSIONS
  Age is an independent predictive factor of GFR loss for patients submitted to radical nephrectomy for cortical renal tumors.
authors.affiliation: Division of Urology, Department of Surgery, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil. fabio_torri@yahoo.com.br
authors.forename: Fabio Cesar Miranda
authors.initials: FC
authors.lastname: Torricelli
authors.forename: Alexandre
authors.initials: A
authors.lastname: Danilovic
authors.forename: Giovanni Scala
authors.initials: GS
authors.lastname: Marchini
authors.forename: Alexandre Crippa
authors.initials: AC
authors.lastname: Sant'Anna
authors.forename: Marcos Francisco
authors.initials: MF
authors.lastname: Dall'Oglio
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004812:Epidemiologic Methods; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007680:Kidney Neoplasms / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors