title: [Continuous observation of changes in renal function after radical nephrectomy].
abstract: OBJECTIVE
  To evaluate continuous change in renal function by various clinical factors after radical nephrectomy (RN).
  
  
  METHODS
  Patients after RN from January 2007 to December 2011 in the First Affiliated Hospital to Soochow University were enrolled, 356 cases continuously enrolled throughout the follow-up process, because of lost, missing data and other material reasons, 185 cases meet the requirements, eventually, including 121 male and 64 female patients, aged from 30 to 88 years (average age: (58 ± 12) years). There were 34 diabetes mellitus, 82 hypertension patients. Open surgery for 132 cases, laparoscopic surgery for 53 cases. Continuous checked serum creatinine at 3, 6, 9, 12, 24, 36, 48, 60, 72 months after RN and calculated to estimated glomerular filtration rate (eGFR) by Modification of Diet in Renal Disease equation.Linear mixed models were carried out to analyze postoperative continuous change in eGFR in multivariate regression analysis postoperative risk factors for changes in renal function.
  
  
  RESULTS
  Overall, there was a subsequent restoration of renal function over the follow-up period. The slope (β) for the relationship between the eGFR and the time since RN was 0.099 (95%CI:0.07-0.13, P < 0.01) indicating that each month after RN was associated with an increase in eGFR of 0.099 ml×min(-1)×(1.73 m(2))(-1)×month(-1). The slope (β) was different between the group with clinical factor and its reference group, but the difference in the next three groups with statistically significant after multivariate regression analysis:diabetic and non-diabetic mellitus patients with a slope (β) of -0.02 and 0.12 (P < 0.01) .Hypertension and non-hypertensive patients with a slope (β) of 0.08 and 0.11 (P < 0.05). Age ≤ 50 years, > 50-65 years and > 65 years patients with a slope (β) of 0.15,0.09 and 0.05 (P < 0.05), respectively. There were 13 new-onset of chronic kidney disease (CKD) after RN, including 9 patients with CKD III and 4 patients with CKD IV.
  
  
  CONCLUSIONS
  Renal function recover continuously during the follow-up period after RN. Preoperative predictors of an increase in eGFR after RN are young age, no diabetes mellitus, no hypertension.
authors.affiliation: Department of Urology, the First Affiliated Hospital to Soochow University, Suzhou 215006, China.
authors.forename: Zhenxing
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Urology, the First Affiliated Hospital to Soochow University, Suzhou 215006, China. Email: pjxmnwk@163.com.
authors.forename: Jinxian
authors.initials: J
authors.lastname: Pu
authors.affiliation: Department of Urology, the First Affiliated Hospital to Soochow University, Suzhou 215006, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Urology, the First Affiliated Hospital to Soochow University, Suzhou 215006, China.
authors.forename: Jigen
authors.initials: J
authors.lastname: Ping
authors.affiliation: Department of Urology, the First Affiliated Hospital to Soochow University, Suzhou 215006, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Zang
authors.affiliation: Department of Urology, the First Affiliated Hospital to Soochow University, Suzhou 215006, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003401:Creatine / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011184:Postoperative Period; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D003401:Creatine