title: Preoperative Chronic Kidney Disease Status is an Independent Prognostic Factor in Patients with Renal Cell Carcinoma.
abstract: OBJECTIVE
  Preoperative chronic kidney disease (CKD) status may affect disease outcomes in patients with renal cell carcinoma (RCC). This study evaluated the influence of preoperative CKD status on clinicopathological features and prognosis in patients with RCC.
  
  
  METHODS
  Between 1999 and 2011, a total of 1855 patients underwent radical nephrectomy at various centers throughout Korea. Of these patients, 1655 had an estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m(2) (non-CKD group) and 200 patients had an eGFR ≥30 but <60 ml/min/1.73 m(2) (CKD group). To reduce the effects of selection bias and potential confounding factors, 600 patients in the non-CKD group were selected by propensity-score matching.
  
  
  RESULTS
  The median age of all patients was 57.3 years (range 20-94 years) and the median follow-up was 35.0 months (range 1-154 months). Comparisons of the propensity-score-matched cohorts showed that T and N stages were more advanced and tumor size was larger in the CKD group than in the non-CKD group (p < 0.05 each). Kaplan-Meier analyses showed that recurrence-free survival, cancer-specific survival (CSS), and overall survival (OS) were significantly lower in the CKD group (p < 0.01 each). Multivariate regression analysis showed that preoperative CKD status was an independent predictor of CSS and OS in patients with RCC (p < 0.05 each).
  
  
  CONCLUSIONS
  Preoperative CKD may be associated with more aggressive features and poorer prognosis in patients with RCC. RCC patients with preoperative CKD should be carefully and frequently followed-up after nephrectomy.
authors: Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, Korea.
authors: Young-Won
authors: YW
authors: Kim
authors: Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, Korea.
authors: Won Tae
authors: WT
authors: Kim
authors: Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, Korea.
authors: Seok Joong
authors: SJ
authors: Yun
authors: Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, Korea.
authors: Sang-Cheol
authors: SC
authors: Lee
authors: Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, Korea.
authors: Wun-Jae
authors: WJ
authors: Kim
authors: Department of Urology, Kyungpook National University College of Medicine, Daegu, Korea.
authors: Yun-Sok
authors: YS
authors: Ha
authors: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Yong Hyun
authors: YH
authors: Park
authors: Department of Urology, Korea University School of Medicine, Seoul, Korea.
authors: Seok Ho
authors: SH
authors: Kang
authors: Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Sung-Hoo
authors: SH
authors: Hong
authors: Department of Urology, Kyungpook National University College of Medicine, Daegu, Korea.
authors: Tae Gyun
authors: TG
authors: Kwon
authors: Department of Urology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Seok-Soo
authors: SS
authors: Byun
authors: Department of Urology, Seoul National University College of Medicine, Seoul, Korea. mdrafael@snu.ac.kr.
authors: Cheol
authors: C
authors: Kwak
authors: Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, Korea. urokyj@chungbuk.ac.kr.
authors: Yong-June
authors: YJ
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy; D011379:Prognosis; D057216:Propensity Score; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology; D012307:Risk Factors; D015996:Survival Rate; D047368:Tumor Burden; D055815:Young Adult