title: Clinical factor affecting the recovery of kidney function in clinically localized renal cell carcinoma patients who underwent nephron-sparing surgery.
abstract: BACKGROUND
  Nephron-sparing surgery (NSS) has become the standard treatment for small renal cell carcinoma because of its comparable oncological outcome and superior patient survival compared to total nephrectomy. However, the precise chronological course of recovery from initial kidney damage and the factors responsible for it remain unknown.
  
  
  METHODS
  Seventy-one patients who underwent NSS were enrolled. To elucidate the chronological changes in kidney function that occur after NSS, the estimated glomerular filtration rate (eGFR) was calculated at different two points, the early (7 days after surgery) and late time points (more than 12 months after surgery), and compared with the preoperative eGFR. Perioperative factors were applied to a multivariate regression model to investigate the factors that most affect patient recovery from nephron damage.
  
  
  RESULTS
  eGFR was decreased at the early time point but had partially recovered at the late time point. Male gender, ischemic time, and tumor size were found to be significant predictors of the initial drop in eGFR. The only significant factor that prevented later functional recovery was the presence of DM.
  
  
  CONCLUSIONS
  Several perioperative factors significantly influence early kidney damage; however, the presence of DM is the only factor affecting the risk of long-term chronic kidney damage.
authors: Department of Urology, Sapporo City General Hospital, Sapporo 060-8604, Japan.
authors: Takahiro
authors: T
authors: Osawa
authors: Hiroshi
authors: H
authors: Harada
authors: Koji
authors: K
authors: Oba
authors: Toshimori
authors: T
authors: Seki
authors: Masaki
authors: M
authors: Togashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000503:physiopathology / Q000601:surgery*; D015331:Cohort Studies; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000379:methods