International Urology and Nephrology

, Volume 46, Issue 4, pp 681–686 | Cite as

Predictive factors for the development of chronic renal insufficiency after renal surgery: a multicenter study

  • Yong Sun Choi
  • Yong Hyun Park
  • Yong-June Kim
  • Seok Ho Kang
  • Seok-Soo Byun
  • Sung-Hoo Hong
Urology - Original Paper

Abstract

Purpose

To evaluate which factors affecting changes in postoperative renal function after conducting radical nephrectomy or partial nephrectomy.

Methods

Data on patients who underwent operations for renal cell carcinoma between 2000 and 2010 at multiple institutions were collected. Patient characteristics including preoperative estimated glomerular filtration rate (EGFR) were investigated, and types of surgery and postoperative results were evaluated. Renal insufficiency was defined as an EGFR <60 ml/min/1.73 m2. Cox proportional hazard regression analysis was used to investigate which factors were associated with chronic renal insufficiency after surgery.

Results

A total of 2,454 patients were included for evaluation; 1,502 patients underwent radical nephrectomy, whereas 952 patients underwent partial nephrectomy. The mean follow-up period was 44.48 ± 27.04 months (range, 12–120 months). Factors affecting EGFR were age, diabetes, hypertension, surgical procedure, and preoperative creatinine level (p < 0.001). Factors affecting postoperative renal insufficiency were age, surgical procedure, serum creatinine level, and EGFR.

Conclusion

The risk for developing post-nephrectomy renal insufficiency in patients who underwent radical nephrectomy was higher than those who underwent partial nephrectomy. Factors affecting post-nephrectomy renal insufficiency were age, preoperative serum creatinine level, and preoperative EGFR. In addition to radical nephrectomy, patient >58 years with a preoperative serum creatinine >1.03 mg/ml, and EGFR <73 ml/min/1.73 m2 had a higher probability of developing post-nephrectomy chronic renal insufficiency.

Keywords

Chronic renal insufficiency Renal cell carcinoma Nephrectomy 

Notes

Acknowledgments

This study was supported by ‘Life Respecting Fund donated by Kim Jong-Nam’ of Seoul St. Mary’s Hospital, The Catholic University of Korea.

Conflict of interest

The Authors have stated that they have no conflicts of interest.

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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Yong Sun Choi
    • 1
  • Yong Hyun Park
    • 2
  • Yong-June Kim
    • 3
  • Seok Ho Kang
    • 4
  • Seok-Soo Byun
    • 5
  • Sung-Hoo Hong
    • 1
    • 6
  1. 1.Department of Urology, College of MedicineThe Catholic University of KoreaSeoulKorea
  2. 2.Department of UrologySeoul National University College of MedicineSeoulKorea
  3. 3.Department of UrologyChungbuk National University College of MedicineCheongjuKorea
  4. 4.Department of UrologyKorea University School of MedicineSeoulKorea
  5. 5.Department of UrologySeoul National University Bundang HospitalSeongnamKorea
  6. 6.Seoul St. Mary’s HospitalSeoulKorea

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