Followup of Unilateral Renal Function After Laparoscopic Partial Nephrectomy

No AccessJournal of UrologyAdult Urology1 Jul 2011Followup of Unilateral Renal Function After Laparoscopic Partial Nephrectomy Cheryn Song, Sejun Park, In Gab Jeong, Jun Hyuk Hong, Hyung Keun Park, Choung-Soo Kim, and Hanjong Ahn Cheryn SongCheryn Song More articles by this author , Sejun ParkSejun Park More articles by this author , In Gab JeongIn Gab Jeong More articles by this author , Jun Hyuk HongJun Hyuk Hong More articles by this author , Hyung Keun ParkHyung Keun Park More articles by this author , Choung-Soo KimChoung-Soo Kim More articles by this author , and Hanjong AhnHanjong Ahn More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.03.021AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assessed the change in unilateral renal function after laparoscopic partial nephrectomy to determine factors affecting the course and factors predicting the postoperative glomerular filtration rate decrease. Materials and Methods: From prospectively collected data on 116 patients who underwent laparoscopic partial nephrectomy we evaluated the glomerular filtration rate of the operated kidney using diethylenetriaminepentaacetic acid scans done preoperatively, and 3 months, and 1, 2 and 3 years postoperatively. Kidney volume was measured from the arterial phase of dynamic computerized tomography of the kidney done before and 3 months postoperatively to calculate the volume reduction. We analyzed clinicopathological and operative factors with the potential to influence the perioperative glomerular filtration rate decrease. Results: In all patients the glomerular filtration rate was significantly decreased by 3 months postoperatively. It remained significantly lower compared to preoperative function despite the trend toward progressive recovery, which was noted until 3 years postoperatively. Recovery in individuals was significantly influenced by patient age (less than 55 vs 55 years or greater), medical comorbidities, tumor size (less than 2.5 vs 2.5 cm or greater), kidney volume reduction (less than 20% vs 20% or greater) and collecting system repair at surgery. Independent determinants of postoperative renal function were the preoperative glomerular filtration rate (β = 0.410, 95% CI 0.424–1.084; p <0.001), the percent of renal parenchymal volume reduction (β = 0.273, 95% CI 0.168–0.766; p = 0.003) and pelvicalyceal system repair (β = 0.284, 95% CI 2.960–15.788; p = 0.005). Conclusions: Function of the kidney undergoing laparoscopic partial nephrectomy progressively recovers after a significant decrease immediately after surgery. 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Link, Google Scholar Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea© 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byTanaka H, Wang Y, Suk-Ouichai C, Palacios D, Caraballo E, Ye Y, Remer E, Li J, Abouassaly R and Campbell S (2019) Can We Predict Functional Outcomes after Partial Nephrectomy?Journal of Urology, VOL. 201, NO. 4, (693-701), Online publication date: 1-Apr-2019.Mir M, Ercole C, Takagi T, Zhang Z, Velet L, Remer E, Demirjian S and Campbell S (2018) Decline in Renal Function after Partial Nephrectomy: Etiology and PreventionJournal of Urology, VOL. 193, NO. 6, (1889-1898), Online publication date: 1-Jun-2015.Takagi T, Mir M, Campbell R, Sharma N, Remer E, Li J, Demirjian S, Kaouk J and Campbell S (2018) Predictors of Precision of Excision and Reconstruction in Partial NephrectomyJournal of Urology, VOL. 192, NO. 1, (30-35), Online publication date: 1-Jul-2014.Mir M, Takagi T, Campbell R, Sharma N, Remer E, Li J, Demirjian S, Stein R, Kaouk J and Campbell S (2018) Poorly Functioning Kidneys Recover from Ischemia after Partial Nephrectomy as Well as Strongly Functioning KidneysJournal of Urology, VOL. 192, NO. 3, (665-670), Online publication date: 1-Sep-2014.Demirjian S, Lane B, Derweesh I, Takagi T, Fergany A and Campbell S (2018) Chronic Kidney Disease Due to Surgical Removal of Nephrons: Relative Rates of Progression and SurvivalJournal of Urology, VOL. 192, NO. 4, (1057-1063), Online publication date: 1-Oct-2014.Takagi T, Mir M, Sharma N, Remer E, Li J, Demirjian S, Kaouk J and Campbell S (2018) Compensatory Hypertrophy after Partial and Radical Nephrectomy in AdultsJournal of Urology, VOL. 192, NO. 6, (1612-1619), Online publication date: 1-Dec-2014. Volume 186Issue 1July 2011Page: 53-58 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordskidneywarm ischemianephrectomylaparoscopykidney function testsMetricsAuthor Information Cheryn Song More articles by this author Sejun Park More articles by this author In Gab Jeong More articles by this author Jun Hyuk Hong More articles by this author Hyung Keun Park More articles by this author Choung-Soo Kim More articles by this author Hanjong Ahn More articles by this author Expand All Advertisement PDF downloadLoading ...