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Kidney Week

Abstract: FR-PO312

Clinical Factors, Non-Neoplastic Histological Variables and Kidney Function in Patients Undergoing Partial Nephrectomy in Solitary Kidneys or Bilateral Partial Nephrectomies

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Munoz Mendoza, Jair, University of Miami, Miami, Florida, United States
  • Pan, Kelsey, University of Miami, Miami, Florida, United States
  • Iakymenko, Oleksii, University of Miami, Miami, Florida, United States
  • Parekh, Dipen, University of Miami, Miami, Florida, United States
  • Contreras, Gabriel, University of Miami, Miami, Florida, United States
  • Bayes santos, Liz Y., University of Miami, Miami, Florida, United States
  • Thomas, David B., University of Miami, Miami, Florida, United States
Background

Significant nephron mass reduction after nephrectomies carries the risk of substantial worsening kidney function. We aimed to evaluate the relationship among clinical, non-neoplastic histological abnormalities and glomerular filtration rate (eGFR) after partial nephrectomy (PN) in solitary kidneys or bilateral PN.

Methods

We studied 57 patients, 24 with PN in a solitary kidney and 33 with bilateral PN. We used Pearson coefficient correlations and logistic regression analyses to evaluate the association between age, hypertension (HTN), diabetes, baseline eGFR, histological variables and post-nephrectomy eGFR at discharge.

Results

The mean age was 62 ± 13 years. The majority had HTN (81%), 23% had diabetes and 46% had chronic kidney disease. The baseline eGFR was 64 ± 26 ml/min/1.73m2. Of the 36 patients with non-neoplastic histological data available, 75% had interstitial fibrosis (IF), 83% had global glomerulosclerosis (GGS) and 92% had arteriosclerosis (AS). Post-nephrectomy eGFR correlated with baseline eGFR (r=0.7; p<0.001) and IF% (r=-0.4, p<0.05), although not statistical significant, there was a trend in the correlation between post-nephrectomy eGFR and GGS% (r=-0.3; p=0.07). In multivariable-adjusted logistic regression analyses, post-nephrectomy eGFR < 45 ml/min/1.73m2 was significantly associated with lower baseline eGFR (odds ratio [OR] per 10 units change in eGFR, 0.5[95% confidence interval (CI), 0.3-0.7)]) and PN in a solitary kidney compared to bilateral PN (OR, 6.6[95% CI, 1.3-34.2])

Conclusion

Lower baseline eGFR levels and PN in a solitary kidney compared with bilateral PN were independently associated with significant greater odds of post-nephrectomy eGFR < 45 ml/min/1.73m2. IF% was significantly correlated with post nephrectomy eGFR.