title: Comparison of postoperative estimated glomerular filtration rate between kidney donors and radical nephrectomy patients, and risk factors for postoperative chronic kidney disease.
abstract: OBJECTIVE
  To compare post-nephrectomy renal function between kidney donors and renal cell carcinoma patients, to evaluate trends in recovery, and to identify factors relevant to renal failure.
  
  
  METHODS
  Patients who had radical or donor nephrectomy from four different institutions between 2003 and 2012 were reviewed. Propensity score matching was carried out and 79 patients were selected for each group. The estimated glomerular filtration rate was calculated using the Modification of Diet in Renal Disease formula preoperatively and postoperatively at 1, 3, 6, 12, 24 and 36 months. Mean estimated glomerular filtration rate was compared, and the difference between preoperative values and each preceding date was calculated. A multivariate logistic regression was used to determine independent factors for a decrease in estimated glomerular filtration rate to <60 mL/min/1.73 m(2) .
  
  
  RESULTS
  The donor nephrectomy group showed a trend of improved estimated glomerular filtration rate recovery at 24 months and 36 months compared with the radical nephrectomy group, which was statistically significant (P = 0.028, P = 0.012). Multivariate logistic regression showed that renal cell carcinoma (odds ratio 4.605, 95% confidence interval 1.626-13.040, P = 0.004), a baseline estimated glomerular filtration rate lower than 110 (odds ratio 4.477, 95% confidence interval 1.360-14.742, P = 0.014) and age older than 40 years (odds ratio 21.616, 95% confidence interval 2.761-169.222, P = 0.003) were predictive factors for a decrease in renal function.
  
  
  CONCLUSIONS
  Renal cell carcinoma is an independent risk factor for chronic kidney disease after nephrectomy. In addition, age older than 40 years and a baseline estimated glomerular filtration rate of 110 mL/min/1.73 m(2) or less seem to represent risk factors associated with chronic kidney disease after nephrectomy.
authors.affiliation: Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Sang Hyub
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Kim
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Seok
authors.initials: S
authors.lastname: Cho
authors.affiliation: Department of Urology, Myongji Hospital, Goyang, Korea.
authors.forename: Sang Jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Seok Ho
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Department of Urology, Eulji University College of Medicine, Daejeon, Korea.
authors.forename: Jinsung
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Urology, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Sung Yul
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Sung-Goo
authors.initials: SG
authors.lastname: Chang
authors.affiliation: Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Jeon
mesh_terms: D000328:Adult; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000601:surgery*; D007680:Kidney Neoplasms / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009392:Nephrectomy / Q000009:adverse effects*; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology*; D020127:Recovery of Function; D051436:Renal Insufficiency, Chronic / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D066027:Transplant Recipients; D055815:Young Adult
keywords: chronic renal insufficiency; kidney; living donors; nephrectomy; renal cell carcinoma