Comparison of glomerular filtration rate (GFR) loss after nephrectomy in 3 populations: Living donor nephrectomy, radical nephrectomy and partial nephrectomy for cancer

Background: Effective follow-up after living kidney donation is important for maintaining the renal function of the donor. We investigated whether the estimated glomerular filtration rate (eGFR) and urinary protein and enzyme levels can provide important information regarding the state of the remaining kidney after donor nephrectomy. Methods: Seventy-five living donations were included (prospective/retrospective) in the study. The following parameters were measured up to 1 year after donor nephrectomy: serum creatinine and cystatin C as markers of the GFR; the high-molecular-weight urinary proteins as markers of glomerular injury; and the low-molecular-weight urinary proteins and urinary enzymes as markers of tubular function. Results: One year after kidney donation, the creatinine and cystatin C values were 1.38-fold increased than their initial values, while the eGFR was 32% lower. At that time, 38% of donors had a moderate or high risk of CKD progression. The biochemical urinary glomerular and tubular kidney markers examined showed different behaviors. After a transient increase, the glomerular proteins normalized. Conversely, the detection of low-molecular-weight urinary proteins and enzymes reflected mild tubular damage at the end of the study period. Conclusions: Our findings suggest that for the evaluation of mild tubular damage, low-molecular-weight marker proteins should be included in the urine diagnostic of a personalized living kidney donor follow-up.

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GLOMERULAR FILTRATION RATE AND PERIOPERATIVE OUTCOMES AFTER PARTIAL NEPHRECTOMY FOR MULTIPLE IPSILATERAL RENAL MASSES

The Journal of Urology ◽

10.1016/s0022-5347(09)61245-3 ◽

2009 ◽

Vol 181 (4S) ◽

pp. 439-439

Author(s):

Miguel A Mercado ◽

Alana M Murphy ◽

Gregory W Hruby ◽

Jaime Landman ◽

Mitchell C Benson ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Partial Nephrectomy ◽

Filtration Rate ◽

Perioperative Outcomes ◽

Renal Masses

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Effect of Baseline Glomerular Filtration Rate on Survival in Patients Undergoing Partial or Radical Nephrectomy for Renal Cortical Tumors

Mayo Clinic Proceedings ◽

10.4065/83.10.1101 ◽

2008 ◽

Vol 83 (10) ◽

pp. 1101-1106 ◽

Cited By ~ 54

Author(s):

Joseph A. Pettus ◽

Thomas L. Jang ◽

Robert H. Thompson ◽

Ofer Yossepowitch ◽

Meagan Kagiwada ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Radical Nephrectomy ◽

Filtration Rate

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Effect of Warm Ischemia Time During Laparoscopic Partial Nephrectomy on Early Postoperative Glomerular Filtration Rate

The Journal of Urology ◽

10.1016/j.juro.2009.02.026 ◽

2009 ◽

Vol 181 (6) ◽

pp. 2438-2445 ◽

Cited By ~ 79

Author(s):

Guilherme Godoy ◽

Vigneshwaran Ramanathan ◽

Jamie A. Kanofsky ◽

Rebecca L. O'Malley ◽

Basir U. Tareen ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Partial Nephrectomy ◽

Filtration Rate ◽

Warm Ischemia ◽

Warm Ischemia Time ◽

Laparoscopic Partial Nephrectomy ◽

Ischemia Time

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The Renal System

10.2310/7ccsp.2255 ◽

2017 ◽

Author(s):

Jayme E. Locke ◽

John T Killian Jr

Keyword(s):

Vitamin D ◽

Acute Kidney Injury ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate ◽

Kidney Injury ◽

Donor Nephrectomy ◽

General Surgeon ◽

Ureteral Injuries ◽

Renal System

This updated review on the renal system provides a concise overview of the topics most important to the general surgeon. Anatomic topics have been expanded to also include variant anatomy and surgical approaches. There is a new focus on the accuracy and utility of equations for estimating the glomerular filtration rate, as well as supplementation and pharmacology for the general surgeon with discussions of vitamin D and erythropoietin. Acute kidney injury is defined; its pathophysiology is discussed; and its management is outlined, highlighting evidence-based practice. Finally, urologic surgery is addressed with a focus on donor nephrectomy and its consequences, as well as the management of iatrogenic ureteral injuries. Key words: acute kidney injury; contrast nephropathy; erythropoiesis-stimulating agents; estimated glomerular filtration rate; iatrogenic ureteral injury; laparoscopic donor nephrectomy; renal surgical anatomy; vitamin D supplementation

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The Renal System

DeckerMed Surgery ◽

10.2310/surg.2255 ◽

2017 ◽

Author(s):

Jayme E. Locke ◽

John T Killian Jr

Keyword(s):

Vitamin D ◽

Acute Kidney Injury ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate ◽

Kidney Injury ◽

Donor Nephrectomy ◽

General Surgeon ◽

Ureteral Injuries ◽

Renal System

This updated review on the renal system provides a concise overview of the topics most important to the general surgeon. Anatomic topics have been expanded to also include variant anatomy and surgical approaches. There is a new focus on the accuracy and utility of equations for estimating the glomerular filtration rate, as well as supplementation and pharmacology for the general surgeon with discussions of vitamin D and erythropoietin. Acute kidney injury is defined; its pathophysiology is discussed; and its management is outlined, highlighting evidence-based practice. Finally, urologic surgery is addressed with a focus on donor nephrectomy and its consequences, as well as the management of iatrogenic ureteral injuries. Key words: acute kidney injury; contrast nephropathy; erythropoiesis-stimulating agents; estimated glomerular filtration rate; iatrogenic ureteral injury; laparoscopic donor nephrectomy; renal surgical anatomy; vitamin D supplementation

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Identifying the predictors of estimated glomerular filtration rate after partial nephrectomy with a nonlinear regression model

International Journal of Clinical Practice ◽

10.1111/ijcp.13763 ◽

2020 ◽

Author(s):

Emre Karabay ◽

Çağatay Tosun ◽

Nejdet Karsiyakali ◽

Kemal Kayar ◽

Serdar Aykan ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Regression Model ◽

Glomerular Filtration ◽

Partial Nephrectomy ◽

Nonlinear Regression ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Nonlinear Regression Model

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Comparison of retroperitoneal and transperitoneal robotic partial nephrectomy by pentafecta perioperative and renal functional outcomes.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.7_suppl.602 ◽

2019 ◽

Vol 37 (7_suppl) ◽

pp. 602-602

Author(s):

Chang Il Choi ◽

Seong Il Seo

Keyword(s):

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Partial Nephrectomy ◽

Tumor Size ◽

Functional Outcomes ◽

Filtration Rate ◽

Operative Time ◽

Estimated Glomerular Filtration Rate ◽

Robotic Partial Nephrectomy ◽

Hospital Stays

602 Background: To compare and analyze surgical, oncological and functional outcomes of transperitoneal (TRPN) and retroperitoneal robotic partial nephrectomy (RRPN). Methods: Out of 566 consecutive patients who underwent RAPN by a single surgeon from December 2008 to July 2017, this study included 523 patients (TRPN 310, RRPN 213) who evaluated preoperative and 1-year postoperative estimated glomerular filtration rate (eGFR). Our primary endpoint was to compare the perioperative and postoperative outcomes of both approaches by the measure of Pentafecta (negative surgical margin, no 30-day complication, warm ischemic time (WIT) ≤25 minutes, return of estimated glomerular filtration rate (eGFR) to > 90% from baseline and no upstaging of chronic kidney disease). Secondary endpoint was to find the factors associated with Pentafecta by multivariate regression analysis. Results: No significant difference was found in terms of age, BMI, laterality, history of hypertension or diabetes, ASA grade, tumor size and RENAL nephrometry score. These outcomes were lower in the RRPN group: operative time [median (IQR) 244 (202-295) vs. 273 (230-314); p < 0.001], WIT [median (IQR) 19 (15-25) vs. 21 (16-27); p < 0.008] and estimated blood loss (EBL) [median (IQR) 100 (60-200) vs. 150 (100-200); p < 0.003]. Hospital stay, baseline eGFR, 1-year postoperative eGFR, the rate of Pentafecta achievement, recurrence and complications were not different. The rate of WIT ≤ 25 minutes was solely significantly different (TRPN 69.7% vs. RRPN 77.9%, p = 0.045) in the Pentafecta criteria. Multivariate analysis revealed tumor size [OR (95% CI) 0.641 (0.536-0.767), p < 0.001) and hospital stays (OR 0.639, p < 0.001) as predictive for lack of Pentafecta. Conclusions: RRPN demonstrated less operative time, WIT and EBL than TPRN. Pentafecta achievements were equivalent in both approaches. Tumor size and hospital stays were found as predictive factors of Pentafecta.

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