title: Prediction of complications after partial nephrectomy by RENAL nephrometry score.
abstract: BACKGROUND
  Discussing and planning the appropriate management for suspicious renal masses can be challenging. With the development of nephrometry scoring methods, we aimed to evaluate the ability of the RENAL nephrometry score to predict both the incidence of postoperative complications and the change in renal function after a partial nephrectomy.
  
  
  METHODS
  This was a retrospective study including 128 consecutive patients who underwent a partial nephrectomy (open and laparoscopic) for renal lesions in a tertiary UK referral centre. Univariate and multivariate ordinal regression models were used to identify associations between Clavien-Dindo classification and explanatory variables. The Kendall rank correlation coefficient was used to examine an association between RENAL nephrometry score and a drop in estimated glomerular filtration rate (eGFR) following surgery.
  
  
  RESULTS
  An increase in the RENAL nephrometry score of one point resulted in greater odds of being in a higher Clavien-Dindo classification after controlling for RENAL suffix and type of surgical procedure (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.04-1.64, p=0.043). Furthermore, a patient with the RENAL suffix 'p' (ie posterior location of tumour) had increased odds of developing more serious complications (OR: 2.60, 95% CI: 1.07-6.30, p=0.042). A correlation was shown between RENAL nephrometry score and postoperative drop in eGFR (Kendall's tau coefficient -0.24, p=0.004).
  
  
  CONCLUSIONS
  To our knowledge, this is the first study that has shown the predictive ability of the RENAL nephrometry scoring system in a UK cohort both in terms of postoperative complications and change in renal function.
authors.affiliation: Norfolk and Norwich University Hospitals NHS Foundation Trust, UK.
authors.forename: U D
authors.initials: UD
authors.lastname: Reddy
authors.forename: R
authors.initials: R
authors.lastname: Pillai
authors.forename: R A
authors.initials: RA
authors.lastname: Parker
authors.forename: J
authors.initials: J
authors.lastname: Weston
authors.forename: N A
authors.initials: NA
authors.lastname: Burgess
authors.forename: E T S
authors.initials: ET
authors.lastname: Ho
authors.forename: R D
authors.initials: RD
authors.lastname: Mills
authors.forename: M A
authors.initials: MA
authors.lastname: Rochester
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D059351:Organ Sparing Treatments / Q000009:adverse effects / Q000379:methods; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index; D055815:Young Adult