Kidney Week

Abstract: TH-PO1145

Determinants of Renal Function After Nephrectomy for Renal Cell Cancer in Ethnic Minorities

Session Information

• CKD: Clinical, Outcomes, Trials - I
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Osei, Albert M., John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, United States

Albert M. Osei,

• Mangla, Ankit M., John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, United States

Ankit M. Mangla,

• Okyne, Edwin, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, United States

Edwin Okyne,

• Mbachi, Chimezie Uchenna, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, United States

Chimezie Uchenna Mbachi,

• Hart, Peter D., John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, United States

Peter D. Hart,

Background

Renal cell cancer, unless metastasized at the time of diagnosis, is treated by partial or radical nephrectomy. Nephrologists are often consulted to predict renal function outcome especially for those with CKD. There is paucity of data on this subject for ethnic minorities.

Methods

Electronic medical records of all patients who underwent partial or radical nephrectomies from 2007 to 2017 in a large inner-city public teaching hospital were reviewed. Inclusion criteria included pathologic confirmation of renal cell cancer. Patients who had repeat nephrectomy of the contralateral kidney were excluded. Demographics, co-morbidity, preoperative and up to two years of postoperative laboratory data were reviewed. CKD was defined as eGFR < 60ml/min/1.73m²and acute kidney injury was staged by AKIN criteria (KDIGO, Kidney Int. (suppl) 2012)

Results

422 patients met the criteria for the analysis. Percentage of African Americans, Hispanics and Caucasians was 36, 31, 29 respectively. Males: Females-62% vs 38% with no ethnic differences. African Americans were older-mean age of Hispanics, Caucasians and African Americans was 51, 53, 56 respectively (P<0.001). Diabetes was present in 24% with no ethnic difference. Hypertension was present in 49% with disproportionate 51% of these being African Americans. 11% had baseline CKD with majority (63%) being African Americans. Partial nephrectomy was performed in 40% compared to radical nephrectomy in 60% with no group differences. Postoperative AKI developed in 54% of patients and was significantly higher with radical nephrectomy than partial nephrectomy (68% vs 39% P< 0.001). At 3 months, postoperative CKD increased to 34%, remained about this level at 2 years and African Americans, Caucasians, Hispanics constituted 52, 24, 16 percent (P=0.001) respectively. Associations with postoperative CKD were African American ethnicity, preexisting CKD, radical nephrectomy, diabetes mellitus, and postoperative AKI (P<0.001 for all)

Conclusion

African Americans compared to other ethnic groups have disproportionately increased risk of chronic kidney disease following nephrectomy and this is partly explained by the higher baseline CKD.