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Contralateral kidney volume change as a consequence of ipsilateral parenchymal atrophy promotes overall renal function recovery after partial nephrectomy

  • Urology - Original Paper
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Abstract

Purpose

To evaluate whether ischemic time is related to ipsilateral parenchymal atrophy (IPA) and contralateral compensational hypertrophy (CCH) and how CCH affects late functional outcome after partial nephrectomy.

Methods

Parenchymal kidney volumes and glomerular filtration rate (GFR) were determined preoperatively and at 3, 6, and 12 months postoperatively in 79 patients. Kidney volume was measured by Voxel Plus® 2.5 with a tissue segmentation tool. Correlation analysis and univariate and multivariate regression models were used to evaluate the recovery of IPA, CCH, and GFR.

Results

The mean preserved ipsilateral kidney volume was 86.7 %. At 12 months, mean IPA and CCH were 3.0 and 4.8 %, respectively, and the mean GFR decrease was 8.0 %. Ipsilateral volume decrease and contralateral volume increase were significant until 6 months postoperatively (p < 0.05, for each). IPA and CCH were greater with a longer ischemic time (>35 min; p = 0.029 and 0.003, respectively), and CCH correlated positively with IPA (r 2 = 0.052, p = 0.045). On multivariate analysis, IPA correlated with a longer ischemic time and percent of preserved normal parenchymal volume (PPV), and CCH correlated with a longer ischemic time, IPA, PPV, and total parenchymal volume increase. At 12 months postoperatively, CCH correlated with GFR recovery (r 2 = 0.072, p = 0.026), and significant predictors of GFR recovery were age, sex, PPV, and CCH.

Conclusions

We present the meaningful possibility that longer ischemic time and less preservation of normal parenchyma cause greater parenchymal atrophy, thereby promoting CCH, which contributes to renal function recovery after partial nephrectomy.

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Abbreviations

BSA:

Body surface area

CCH:

Contralateral compensatory hypertrophy

CKV:

Contralateral kidney parenchymal volume

EBL:

Estimated blood loss

GFR:

Glomerular filtration rate

IKV:

Ipsilateral kidney parenchymal volume

IPA:

Ipsilateral parenchymal atrophy

PPV:

Percent of preserved normal parenchymal volume

TKV:

Total kidney parenchymal volume

References

  1. Becker F, Van Poppel H, Hakenberg OW, Stief C, Gill I, Guazzoni G, Montorsi F, Russo P, Stockle M (2009) Assessing the impact of ischaemia time during partial nephrectomy. Eur Urol 56(4):625–634

    Article  PubMed  Google Scholar 

  2. Choi JD, Park JW, Choi JY, Kim HS, Jeong BC, Jeon SS, Lee HM, Choi HY, Seo SI (2010) Renal damage caused by warm ischaemia during laparoscopic and robot-assisted partial nephrectomy: an assessment using Tc 99 m-DTPA glomerular filtration rate. Eur Urol 58(6):900–905

    Article  PubMed  Google Scholar 

  3. Simmons MN, Lieser GC, Fergany AF, Kaouk J, Campbell SC (2013) Association between warm ischemia time and renal parenchymal atrophy after partial nephrectomy. J Urol 189(5):1638–1642

    Article  PubMed  Google Scholar 

  4. Simmons MN, Fergany AF, Campbell SC (2011) Effect of parenchymal volume preservation on kidney function after partial nephrectomy. J Urol 186(2):405–410

    Article  PubMed  Google Scholar 

  5. Song C, Park S, Jeong IG, Hong JH, Park HK, Kim CS, Ahn H (2011) Followup of unilateral renal function after laparoscopic partial nephrectomy. J Urol 186(1):53–58

    Article  PubMed  Google Scholar 

  6. Funahashi Y, Hattori R, Yamamoto T, Kamihira O, Kato K, Gotoh M (2009) Ischemic renal damage after nephron-sparing surgery in patients with normal contralateral kidney. Eur Urol 55(1):209–215

    Article  PubMed  Google Scholar 

  7. Jeon HG, Choi KH, Kim KH, Rha KH, Yang SC, Han WK (2012) Comparison of video-assisted minilaparotomy, open, and laparoscopic partial nephrectomy for renal masses. Yonsei Med J 53(1):151–157

    Article  PubMed Central  PubMed  Google Scholar 

  8. Desai MM, Gill IS, Ramani AP, Spaliviero M, Rybicki L, Kaouk JH (2005) The impact of warm ischaemia on renal function after laparoscopic partial nephrectomy. BJU Int 95(3):377–383

    Article  PubMed  Google Scholar 

  9. Jeon HG, Lee SR, Joo DJ, Oh YT, Kim MS, Kim YS, Yang SC, Han WK (2010) Predictors of kidney volume change and delayed kidney function recovery after donor nephrectomy. J Urol 184(3):1057–1063

    Article  PubMed  Google Scholar 

  10. Funahashi Y, Hattori R, Yamamoto T, Kamihira O, Moriya Y, Gotoh M (2009) Change in contralateral renal parenchymal volume 1 week after unilateral nephrectomy. Urology 74(3):708–712

    Article  PubMed  Google Scholar 

  11. Tanaka N, Fujimoto K, Tani M, Yoshii M, Yoshida K, Hirao Y, Ozono S (2004) Prediction of postoperative renal function by preoperative serum creatinine level and three-dimensional diagnostic image reconstruction in patients with renal cell carcinoma. Urology 64(5):904–908

    Article  PubMed  Google Scholar 

  12. Brenner BM, Levine SA, Rector FC, LLC MDC (2004) Brenner and rector’s the kidney, vol 3, 7th edn. Saunders, Philadelphia

  13. Sharma N, O’Hara J, Novick AC, Lieber M, Remer EM, Herts BR (2008) Correlation between loss of renal function and loss of renal volume after partial nephrectomy for tumor in a solitary kidney. J Urol 179(4):1284–1288

    Article  PubMed  Google Scholar 

  14. Wesson LG (1989) Compensatory growth and other growth responses of the kidney. Nephron 51(2):149–184

    Article  CAS  PubMed  Google Scholar 

  15. Vercauteren SR, Ysebaert DK, De Greef KE, Eyskens EJ, De Broe ME (1999) Chronic reduction in renal mass in the rat attenuates ischemia/reperfusion injury and does not impair tubular regeneration. J Am Soc Nephrol 10(12):2551–2561

    CAS  PubMed  Google Scholar 

  16. Natesan S, Reddy SR (2001) Compensatory changes in enzymes of arginine metabolism during renal hypertrophy in mice. Comp Biochem Physiol B Biochem Mol Biol 130(4):585–595

    Article  CAS  PubMed  Google Scholar 

  17. Lane BR, Babineau DC, Poggio ED, Weight CJ, Larson BT, Gill IS, Novick AC (2008) Factors predicting renal functional outcome after partial nephrectomy. J Urol 180(6):2363–2368

    Article  PubMed  Google Scholar 

  18. Adamy A, Favaretto RL, Nogueira L, Savage C, Russo P, Coleman J, Guillonneau B, Touijer K (2010) Recovery of renal function after open and laparoscopic partial nephrectomy. Eur Urol 58(4):596–601

    Article  PubMed  Google Scholar 

  19. Song C, Bang JK, Park HK, Ahn H (2009) Factors influencing renal function reduction after partial nephrectomy. J Urol 181(1):48–53

    Article  PubMed  Google Scholar 

  20. Mir MC, Campbell RA, Sharma N, Remer EM, Simmons MN, Li J, Demirjian S, Kaouk J, Campbell SC (2013) Parenchymal volume preservation and ischemia during partial nephrectomy: functional and volumetric analysis. Urology 82(2):263–268

    Article  PubMed  Google Scholar 

  21. Choi KH, Yang SC, Lee SR, Jeon HG, Kim DS, Joo DJ, Kim MS, Kim YS, Kim SI, Han WK (2011) Standardized video-assisted retroperitoneal minilaparotomy surgery for 615 living donor nephrectomies. Transpl Int 24(10):973–983

    Article  PubMed  Google Scholar 

  22. Pagtalunan ME, Olson JL, Tilney NL, Meyer TW (1999) Late consequences of acute ischemic injury to a solitary kidney. J Am Soc Nephrol 10(2):366–373

    CAS  PubMed  Google Scholar 

  23. Finley DS, Lee DI, Eichel L, Uribe CA, McDougall EM, Clayman RV (2005) Fibrin glue-oxidized cellulose sandwich for laparoscopic wedge resection of small renal lesions. J Urol 173(5):1477–1481

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This work was supported by a Yonsei University College of Medicine faculty research grant for 2010 (6-2010-0085) from Yonsei University College of Medicine, Korea.

Conflict of interest

The authors have no competing interests.

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Authors and Affiliations

  1. Department of Urology, Urological Science Institute, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, 120-752, Korea

    Kyung Hwa Choi, Young Eun Yoon & Woong Kyu Han

  2. Department of Urology, CHA Bundang Medical Center, CHA University, Bundang-gu, Seongnam-si, Korea

    Kyung Hwa Choi

  3. Department of Urology, Ewha Womans University Mokdong Hospital, Seoul, Korea

    Kwang Hyun Kim

Authors
  1. Kyung Hwa Choi
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  2. Young Eun Yoon
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Correspondence to Woong Kyu Han.

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Choi, K.H., Yoon, Y.E., Kim, K.H. et al. Contralateral kidney volume change as a consequence of ipsilateral parenchymal atrophy promotes overall renal function recovery after partial nephrectomy. Int Urol Nephrol 47, 25–32 (2015). https://doi.org/10.1007/s11255-014-0847-2

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  • DOI: https://doi.org/10.1007/s11255-014-0847-2

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