PD66-05 USE OF INTRAOPERATIVE MANNITOL DURING PARTIAL NEPHRECTOMY FAILS TO PROVIDE SHORT-TERM OR LONG-TERM RENAL FUNCTION BENEFIT – EVEN IN HIGH RISK POPULATIONS

Abstract Funding Acknowledgements Type of funding sources: None. Background Recent emphasis on reduced duration and/or intensity of antiplatelet therapy following PCI irrespective of indication for PCI may fail to account for the substantial risk of subsequent nontarget lesion events in acute coronary syndrome (ACS) patients. This study sought to investigate the beneﬁts and risks of extended-term (>12-month) DAPT as compared with short-term DAPT in high-risk "TWILIGHT-like" ACS patients undergoing PCI. Methods All consecutive patients fulﬁlling the "TWILIGHT-like" criteria undergoing PCI from January 2013 to December 2013 were identiﬁed from the prospective Fuwai PCI Registry. High-risk "TWILIGHT-like" patients were deﬁned by at least 1 clinical and 1 angiographic feature based on TWILIGHT trial selection criteria. The present analysis evaluated 4,875 high-risk "TWILIGHT-like" patients with ACS who were event-free at 12 months after PCI. The primary outcome was the composite of all-cause death, myocardial infarction (MI), or stroke at 30 months while BARC type 2, 3, or 5 bleeding was key secondary outcome. Results Extended DAPT compared with shorter DAPT reduced the composite outcome of all-cause death, MI, or stroke by 63% (1.5% vs. 3.8%; HRadj: 0.374, 95% CI: 0.256 to 0.548; HRmatched: 0.361, 95% CI: 0.221-0.590). The HR for cardiovascular death was 0.049 (0.007 to 0.362) and that for MI 0.45 (0.153 to 1.320) and definite/probable stent thrombosis 0.296 (0.080-1.095) in propensity-matched analyses. Rates of BARC type 2, 3, or 5 bleeding (0.9% vs. 1.3%; HRadj: 0.668 [0.379 to 1.178]; HRmatched: 0.721 [0.369-1.410]) did not differ significantly in patients treated with DAPT > 12-month or DAPT ≤ 12-month. The effect of long-term DAPT on primary and key secondary outcome across the proportion of ACS patients with 1-3, 4-5, or 6-9 risk factors showed a consistent manner (Pinteraction > 0.05). Conclusion Among high-risk "TWILIGHT-like" patients with ACS after PCI, long-term DAPT reduced ischemic events without increasing clinically meaningful bleeding events as compared with short-term DAPT, suggesting that extended DAPT might be considered in the treatment of ACS patients who present with a particularly higher risk for thrombotic complications. Abstract Figure.

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MO388DEVELOPMENT OF ACUTE KIDNEY INJURY DURING A RHABDOMYOLYSIS EPISODE: DIFFERENCES IN LONG-TERM KIDNEY FUNCTION

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab082.0042 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Sara Núñez Delgado ◽

Miren Iriarte-Abril ◽

Júlia Farrera-Núñez ◽

Sergi Pascual-Sánchez ◽

Laia Sans-Atxer ◽

...

Keyword(s):

Cardiovascular Disease ◽

Chronic Kidney Disease ◽

Acute Kidney Injury ◽

Renal Function ◽

Kidney Function ◽

Kidney Injury ◽

Inpatient Mortality ◽

Short Term ◽

Worse Prognosis

Abstract Background and Aims Acute renal failure (AKI) associated to rhabdomyolysis conditions a worse prognosis in short-term, its implication in the long-term renal function has been less evaluated. Method Retrospective analysis of patients diagnosed with rhabdomyolysis defined by creatinine kinase > 5000 IU/L between 2015-2019. Basal and 12-month renal function was evaluated. AKI was classified as either non-severe (AKI-KDIGO 1/2) or severe (AKI-KDIGO 3). Results Eighty-seven patients were included, 25 (28.74%) had some degree of chronic kidney disease (CKD) on admission. 56 (64.37%) had AKI on admission, 17 of which were severe (6 required hemodialysis). The patients with AKI had more cardiovascular disease (CVD) and worse analytical parameters on admission (table). Patients with severe AKI showed no difference in CVD from those with non-severe AKI but were younger and had more hyperkalemia. There were no significant differences between patients with severe AKI who required hemodialysis and those who did not. Inpatient mortality was 8%, higher in patients with AKI but without differences according to severity. In 45 patients kidney function was available 12 months after the episode, loss of eGF was -4.90 ± 14.35 ml/min-1.73m2 (p=0.007). There was no difference between patients who developed AKI and those who did not (-4.10 ± 14.4 vs. -5.39 ± 14.57 ml/min-1.73m2; p=0.67), nor between non-severe and severe AKI (-5.50 ± 14.76 vs. -5.12 ± 15.08ml/min-1.73m2; p=0.98). Of the 33 patients without previous CKD, 5 developed CKD, with greater decrease in eGF than those who did not (-22.69 ± 6.04 vs. -2.63 ± 13.92 ml/min-1.73m2; p=0.003). Female sex (60% vs. 12%; p=0.031) and previous basal eGF (72.22 ± 4.37 vs. 95.6±19.97 ml/min-1.72m2; p=0.016) were related to this deterioration. Conclusion After an episode of rhabdomyolysis, the loss of eGF is similar in patients who develop AKI compared to those who do not.

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The association between the anatomical features of renal tumours and the functional outcomes of robot-assisted partial nephrectomy

Canadian Urological Association Journal ◽

10.5489/cuaj.1642 ◽

2014 ◽

Vol 8 (11-12) ◽

pp. 810 ◽

Cited By ~ 3

Author(s):

Jeong Woo Lee ◽

Sung Yong Cho ◽

Chanhoo Jeon ◽

Kyungtae Ko ◽

Hyeon Hoe Kim

Keyword(s):

Renal Function ◽

High Risk ◽

Functional Outcome ◽

Partial Nephrectomy ◽

Magnetic Resonance Images ◽

Robot Assisted ◽

Computed Tomography Images ◽

Postoperative Renal Function ◽

Renal Tumours ◽

Clinical Records

Introduction: We evaluated the the association between PADUA scores and postoperative renal function (after robot-assisted partial nephrectomy [RAPN]) and between PADUA scores and warm ischemic time (during RAPN).Methods: We reviewed the clinical records of 106 patients who underwent RAPN for a single localized renal tumour between April 2009 and June 2012. Postoperative renal function was evaluated using estimated glomerular filtration rate (eGFR) in 85 patients who were followed for at least 6 months. PADUA scores for renal tumours were calculated using contrast-enhanced computed tomography images, if needed, along with magnetic resonance images in some cases.Results: A PADUA score ≥10 and WIT ≥30 minutes were observed in 18 (17.0%) and 51 (48.1%) cases, respectively. PADUA scores were significantly correlated with WIT (p = 0.019) and percent change in eGFR at 6 months postoperatively (p = 0.005). PADUA score (continuous variable, odds ratio [OR] 1.694, p = 0.007) and the high-risk group (PADUA score ≥10) (OR 5.429; p = 0.020) were significantly associated with a WIT of ≥30 minutes by multivariate analysis. A 1-point increase in the PADUA score was associated with an eGFR decrease of >20% at 6 months after RAPN (OR 1.799; p = 0.076). In addition, a PADUA score ≥10, or high risk, (OR 13.965; p = 0.003) was an independent predictor of an eGFR decrease of >20% at 6 months after RAPN.Conclusions: The PADUA classification can reliably predict WIT and postoperative renal functional outcome after RAPN. Furthermore, the study suggests that anatomical aspects of renal tumours are associated with functional outcome after RAPN.

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Long term renal function following selective angioembolization for iatrogenic vascular lesions after partial nephrectomy: A matched case-control study

Investigative and Clinical Urology ◽

10.4111/icu.20200510 ◽

2021 ◽

Vol 62 ◽

Author(s):

Ragheed Saoud ◽

Nassib Abou Heidar ◽

Joshua Aizen ◽

Ciro Andolfi ◽

Logan Galansky ◽

...

Keyword(s):

Renal Function ◽

Partial Nephrectomy ◽

Case Control Study ◽

Case Control ◽

Vascular Lesions ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

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Combined Androgen Blockade in Localized Prostate Cancer Treated With Definitive Radiation Therapy

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2019.7335 ◽

2019 ◽

Vol 17 (12) ◽

pp. 1497-1504

Author(s):

Lucas K. Vitzthum ◽

Chris Straka ◽

Reith R. Sarkar ◽

Rana McKay ◽

J. Michael Randall ◽

...

Keyword(s):

Prostate Cancer ◽

Radiation Therapy ◽

High Risk ◽

Cox Proportional Hazards ◽

Hazard Ratio ◽

Short Term ◽

Combined Androgen Blockade ◽

Significant Difference ◽

Androgen Blockade

Background: The addition of androgen deprivation therapy to radiation therapy (RT) improves survival in patients with intermediate- and high-risk prostate cancer (PCa), but it is not known whether combined androgen blockade (CAB) with a gonadotropin-releasing hormone agonist (GnRH-A) and a nonsteroidal antiandrogen improves survival over GnRH-A monotherapy. Methods: This study evaluated patients with intermediate- and high-risk PCa diagnosed in 2001 through 2015 who underwent RT with either GnRH-A alone or CAB using the Veterans Affairs Informatics and Computing Infrastructure. Associations between CAB and prostate cancer–specific mortality (PCSM) and overall survival (OS) were determined using multivariable regression with Fine-Gray and multivariable Cox proportional hazards models, respectively. For a positive control, the effect of long-term versus short-term GnRH-A therapy was tested. Results: The cohort included 8,423 men (GnRH-A, 4,529; CAB, 3,894) with a median follow-up of 5.9 years. There were 1,861 deaths, including 349 resulting from PCa. The unadjusted cumulative incidences of PCSM at 10 years were 5.9% and 6.9% for those receiving GnRH-A and CAB, respectively (P=.16). Compared with GnRH-A alone, CAB was not associated with a significant difference in covariate-adjusted PCSM (subdistribution hazard ratio [SHR], 1.05; 95% CI, 0.85–1.30) or OS (hazard ratio, 1.02; 95% CI, 0.93–1.12). For high-risk patients, long-term versus short-term GnRH-A therapy was associated with improved PCSM (SHR, 0.74; 95% CI, 0.57–0.95) and OS (SHR, 0.82; 95% CI, 0.73–0.93). Conclusions: In men receiving definitive RT for intermediate- or high-risk PCa, CAB was not associated with improved PCSM or OS compared with GnRH alone.

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MP31-19 LONG-TERM FOLLOW-UP OF RENAL FUNCTION AND DEVELOPMENT OF CHRONIC KIDNEY DISEASE AFTER PARTIAL NEPHRECTOMY

The Journal of Urology ◽

10.1097/01.ju.0000557568.28232.a8 ◽

2019 ◽

Vol 201 (Supplement 4) ◽

Author(s):

Takashi Ikeda* ◽

Toshio Takagi ◽

Hiroki Ishihara ◽

Hironori Fukuda ◽

Kazuhiko Yoshida ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Partial Nephrectomy ◽

Long Term Follow Up

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Fathers' Hospital Visits to Their Preterm Infants as a Predictor of Father-Infant Relationship and Infant Development

PEDIATRICS ◽

10.1542/peds.86.2.289 ◽

1990 ◽

Vol 86 (2) ◽

pp. 289-293

Author(s):

Rachel Levy-Shiff ◽

Michael A. Hoffman ◽

Salli Mogilner ◽

Susan Levinger ◽

Mario B. Mogilner

Keyword(s):

Weight Gain ◽

Longitudinal Study ◽

High Risk ◽

Preterm Infants ◽

Infant Development ◽

Short Term ◽

Development Data ◽

Hospital Visits

This short-term longitudinal study assessed the degree to which the frequency of fathers' visits with their preterm infants in the hospital was associated with the quality of ongoing and long-term fathering and infant development. Data on fathering and infant development were collected during the hospital stay, at discharge, at 8 months of age, and at 18 months of age, using both questionnaires and observational schedules. The frequency of visits was significantly correlated with more extensive and positive patterns of fathering at discharge and later periods. It was also associated with more positive perceptions of the infant, as well as with weight gain during hospitalization and psychosocial aspects of later infant development during the first 18 months. The discussion emphasized possible ways in which early paternal contact in the hospital might influence fathers, mothers, and infants. The frequency of paternal visits was highlighted as a variable useful in predicting high-risk parenting.

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