title: Measuring the Impact of Medical Chronic Kidney Disease and Diabetes Mellitus on Renal Functional Decline Following Surgical Management of Renal Masses.
abstract: To identify risk factors for renal functional decline following extirpative renal surgery, and establish the relative impact of these factors on glomerular filtration rate (GFR).
  
  
  
  We reviewed 224 consecutive patients with a normal contralateral kidney who underwent radical nephrectomy for a renal mass at a tertiary care center between 2002 and 2010. Multivariate linear regression was used to identify independent predictors of renal function.
  
  
  
  Mean patient age at time of surgery was 62.6 years and 58% of patients were male. On multivariate analysis, preoperative GFR and diabetes mellitus (DM) were independent predictors of 1-year postoperative renal function. Every 1.0 mL/min/1.73 m(2) of preoperative GFR corresponded to a loss of 0.50 mL/min/1.73 m(2) following extirpative renal surgery. Diabetic patients had a further decrease in GFR of 4.5 mL/min/1.73 m(2) (95% confidence interval 1.5-7.6) compared to patients without DM.
  
  
  
  Preoperative GFR and DM were independent predictors of postoperative renal function. This may represent a proportion of patients with medical renal disease that is not identified on the basis of preoperative GFR alone.
authors.affiliation: Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Surgery, Division of Urology, London Health Sciences Center, Western University, London, Ontario, Canada.
authors.forename: Adiel E
authors.initials: AE
authors.lastname: Mamut
authors.affiliation: Department of Surgery, Division of Urology, London Health Sciences Center, Western University, London, Ontario, Canada.
authors.forename: Philippe D
authors.initials: PD
authors.lastname: Violette
authors.affiliation: Department of Surgery, Division of Urology, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Neal E
authors.initials: NE
authors.lastname: Rowe
authors.affiliation: Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
authors.forename: Fulan
authors.initials: F
authors.lastname: Cui
authors.affiliation: Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Surgery, Division of Urology, London Health Sciences Center, Western University, London, Ontario, Canada. Electronic address: patrick.luke@lhsc.on.ca.
authors.forename: Patrick P
authors.initials: PP
authors.lastname: Luke
mesh_terms: D048909:Diabetes Complications / Q000150:complications*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology*; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012189:Retrospective Studies