title: The effect of contralateral kidney volume on renal function after radical nephroureterectomy: Implications for eligibility for neoadjuvant chemotherapy for upper tract urothelial cancer.
abstract: We investigated the effect of preoperative contralateral kidney (CK) volume on renal function after radical nephroureterectomy (RNU).
  
  
  
  We reviewed 630 patients who underwent RNU between September 1994 and December 2013. Of these 630 patients, 135 patients with advanced upper tract urothelial cancer were ultimately included. Preoperative CK volume was measured from computed tomography images of the venous phase using a specialized volumetric program. Glomerular filtration rate (GFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations and checked preoperatively, 7 days, 1, 3, and 12 months postoperatively.
  
  
  
  The mean age at surgery was 62.1 (10.1) years and the mean CKD-EPI GFR was 73.8 (75.5) ml/min/1.73m2. After RNU, new-onset CKD was identified in 69 (51.1%) patients. On multivariate logistic regression analysis, high body mass index (95% CI: 1.08-1.51, P = 0.005), low preoperative CKD-EPI GFR (95% CI: 0.92-0.98, P = 0.037), and low CK volume (95% CI: 0.96-0.99, P<0.001) were associated with new-onset CKD at 1 month after RNU. There was a positive correlation between CK volume and CKD-EPI GFR at 1 month after RNU (Spearman ρ = 0.495, P<0.001). When stratified according to CK volume, CK volume less than 150ml was significantly associated with new-onset CKD after RNU (95% CI: 2.49-26.29, P = 0.001).
  
  
  
  High body mass index, low preoperative CKD-EPI GFR, and low CK volume are significantly associated with new-onset CKD. Therefore, they could be used to identify patients eligible for neoadjuvant chemotherapy in upper tract urothelial cancer.
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Wan
authors.initials: W
authors.lastname: Song
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hyun Hwan
authors.initials: HH
authors.lastname: Sung
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Deok Hyun
authors.initials: DH
authors.lastname: Han
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Byong Chang
authors.initials: BC
authors.lastname: Jeong
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Seong Il
authors.initials: SI
authors.lastname: Seo
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Seong Soo
authors.initials: SS
authors.lastname: Jeon
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hyun Moo
authors.initials: HM
authors.lastname: Lee
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Han Yong
authors.initials: HY
authors.lastname: Choi
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: hwanggyun.jeon@samsung.com.
authors.forename: Hwang Gyun
authors.initials: HG
authors.lastname: Jeon
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D002945:Cisplatin / Q000627:therapeutic use; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D007677:Kidney Function Tests; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects / Q000379:methods; D000074682:Nephroureterectomy / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014516:Ureteral Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: Chemotherapy; Chronic kidney disease; Kidney volume; Nephroureterectomy; Urothelial carcinoma