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Characterization of mild and severe post-radical nephrectomy renal functional deterioration utilizing histopathological evaluation of non-neoplastic nephrectomized renal parenchyma

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Abstract

Background

We investigated factors affecting mild (MRFD) and severe renal functional deterioration (SRFD) after radical nephrectomy with a special focus on the histopathology of nephrectomized non-neoplastic renal parenchyma.

Methods

MRFD was defined as a postoperative decline of percent estimated glomerular filtration rate (eGFR) lower than the value of the mean minus standard deviation (SD). SRFD was defined as a rate greater than the value of the mean plus SD. The histopathological factors of global glomerulosclerosis (GS) and arteriosclerosis in non-neoplastic renal parenchyma and multiple clinical factors were analyzed to determine whether they affected postoperative renal functional deterioration in 100 renal cell carcinoma cases. The prognoses, including non-cancer mortality, were collected from long-term follow-up data.

Results

A higher preoperative eGFR and a higher global GS extent in non-neoplastic renal parenchyma were independently associated with MRFD and SRFD, respectively. The cardiovascular disease-specific survival rates of the SRFD group and the group with global GS extent >14 % were significantly worse than those of their counterparts.

Conclusions

This is the first report to identify global GS extent in nephrectomized non-neoplastic renal parenchyma as a factor affecting the development of life-threatening post-nephrectomy renal functional deterioration. Moreover, we are the first to advocate the importance of the characterization of favorable post-nephrectomy renal functional deterioration. The identification of MRFD and SRFD by histopathological evaluation of nephrectomized non-neoplastic renal parenchyma will contribute to personalized postoperative follow-up. It may improve follow-up of individual patients with SRFD by permitting collaboration with other clinical departments such as cardiology.

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Authors and Affiliations

  1. Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago, 683-8504, Japan

    Takehiro Sejima, Tetsuya Yumioka, Noriya Yamaguchi, Hideto Iwamoto, Toshihiko Masago, Shuichi Morizane, Masashi Honda & Atsushi Takenaka

Authors
  1. Takehiro Sejima
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  2. Tetsuya Yumioka
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  3. Noriya Yamaguchi
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  4. Hideto Iwamoto
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  5. Toshihiko Masago
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  6. Shuichi Morizane
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  7. Masashi Honda
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  8. Atsushi Takenaka
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Correspondence to Takehiro Sejima.

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Sejima, T., Yumioka, T., Yamaguchi, N. et al. Characterization of mild and severe post-radical nephrectomy renal functional deterioration utilizing histopathological evaluation of non-neoplastic nephrectomized renal parenchyma. Int J Clin Oncol 21, 588–594 (2016). https://doi.org/10.1007/s10147-015-0909-1

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  • DOI: https://doi.org/10.1007/s10147-015-0909-1

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