title: Predictors of postoperative renal functional damage after nephron-sparing surgery.
abstract: BACKGROUND
  Although nephron-sparing surgery has been reported not to affect total renal function, it is a non-negligible fact that functional damage of the operated kidney usually results, for various reasons. This study aimed to explore the effects of preoperative baseline characteristics, tumor characteristics, and function protection methods on postoperative renal damage.
  
  
  METHODS
  This study was a retrospective review of 51 patients who underwent open nephron-sparing surgery. The mean age of the patients (39 men, 12 women) was 54.2 ± 13.9 years, range 32 to 71 years. The glomerular filtration rate (GFR) was measured preoperatively and 6th months after the operation. Univariate analysis was used to screen indicators with significant differences in different levels of renal function damage. All variables found to be significant on univariate analysis were entered into a multiple logistic regression model to predict risk factors for renal function damage.
  
  
  RESULTS
  Univariate analysis showed that there was a significant difference in age, GFR of operated kidney, tumor diameter, tumor depth, and ischemic protection type between patients with little damage and those with heavy damage (P < 0.05). Forward stepwise logistic regression analysis suggested that age (odds ratio, 3.08; 95% confidence interval 1.78 to 7.04; P = 0.037), preoperative GFR of operated kidney (odds ratio, 0.51; 95% confidence interval 0.11 to 0.73; P = 0.033), and tumor diameter (odds ratio, 5.49; 95% confidence interval 2.14 to 7.88; P = 0.012) and depth (odds ratio, 5.82; 95% confidence interval 2.66 to 8.06; P = 0.010) were independent risk factors for postoperative renal function damage.
  
  
  CONCLUSIONS
  Patients with older age, poor renal function, and large tumor diameter and depth might be at higher risk of renal function damage after nephron-sparing surgery.
authors.affiliation: Department of Urology, Xinhua Hospital, School of Medicine, Shanghai JiaoTong University, No,1665 Kongjiang Road, Yangpu District, Shanghai, 200092, China. jasonqi@sh163.net.
authors.forename: Jun
authors.initials: J
authors.lastname: Qi
authors.forename: Yongjiang
authors.initials: Y
authors.lastname: Yu
authors.forename: Tao
authors.initials: T
authors.lastname: Huang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Bai
authors.forename: Jian
authors.initials: J
authors.lastname: Kang
authors.forename: Junhao
authors.initials: J
authors.lastname: Liang
authors.forename: Yu
authors.initials: Y
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D007677:Kidney Function Tests; D007680:Kidney Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000009:adverse effects*; D009399:Nephrons / Q000601:surgery*; D059351:Organ Sparing Treatments; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies