e15576 Background: Chronic kidney disease (CKD) is an independent risk factor for death from all causes. However Japanese individuals tend to have a different lifestyle, including diet and other behavior, than Western individuals and in Japanese some studies show a lower prevalence of obesity and atherosclerosis. To evaluate longitudinal change in renal function after laparoscopic partial nephrectomy (LPN) with renal tumors, we investigate predict risk factor which affect a decrement of renal function. Methods: A nation-wide survey was performed by the LPN study group under the support of Japanese Society of Endourology. Of the 228 insitutes, 63 (28%) insitutes had more than 10 LPN experience. Between Dec 1998 and Dec 2008, 1,375 Japanese patients underwent LPN. Patients with solitary kidney, preoperative eGFR below 45ml/min/1.73m2 were excluded from analysis. Thus, 915 patients were enrolled in this study. Multivariate analysis was performed examining factors associated with the development of de novo eGFR<45 and 60. Results: Patient charcteristics: median age 60 yrs (IQR 50-69), male/female 672/243, hypertension 307 (34%), diabetes mellitus 149 (16%), hyperlipidemia 115 (12%), median BMI 23.8 (IQR 22-26), mean ASA score 1.6±0.6., median tumor size was 2.1 cm (IQR 1.7–2.8), median preoperative eGFR 74 (IQR 64-86). Pedicle clamping was done in 674 cases (73%). The 1-year probability of new onset of an eGFR less than 60 and 45 was 20.0% and 5.6%, respectively. A multivariate model revealed that age, tumor size and preoperative eGFR are independently predictive of de novo eGFR<45. Nomogram was developed based on a multivariate logistic regression model. The area under the ROC curve for de novo eGFR<45 was 0.930. Conclusions: Compared with radical nephrectomy, LPN could preserve renal function. But, even in Japanese, patients undergoing LPN had high comorbidity and 20% of patients developed de novo eGFR<60. We developed novel predictive models for CKD after LPN. This nomogram provides important implications in clinical decision making regarding treatment options or follow-up strategy.
976 Predictors of overall and new-onset renal function impairment after partial nephrectomy: Results from two-years follow up of a prospective multicentre study (RECORd 1 project)
