Correlation between bilateral GFR in patients with localized renal cancer after partial nephrectomy,International Urology and Nephrology

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Correlation between bilateral GFR in patients with localized renal cancer after partial nephrectomy
International Urology and Nephrology ( IF 1.8 ) Pub Date : 2023-12-23 , DOI: 10.1007/s11255-023-03901-w
Wu Wensong ₁ , Chang Fan _{2,

3} , Zhang Jianghui _{2,

3} , Tang Shuai _{2,

3} , Lv Zheng _{2,

3} , Liu Xuehui _{2,

4} , Chen Fangmin _{2,

3}

Affiliation

Objective

To explore the relationship between the residual glomerular filtration rate (GFR) on the operated side and the GFR on the contralateral side following partial nephrectomy (PN) in patients with localized renal cell carcinoma (RCC).

Materials and methods

Following institutional review board approval, we conducted a retrospective analysis of clinical records from May 2018 to July 2023, involving 118 patients who underwent partial nephrectomy for unilateral localized kidney tumors (T1–T2). Glomerular filtration rate data were assessed using single photon emission computed tomography (SPECT)/computed tomography imaging [using 9mTc-DTPA (diethylenetriaminepentaacetic acid) renal dynamic imaging]. The independent determinants of postoperative renal function or renal function change were determined using linear regression analysis. In addition, the patient's demographic, clinical, and nephrometry characteristics were collected.

Results

A total of 58 patients were finally enrolled. The preoperative and postoperative GFR of bilateral kidneys showed a significant positive correlation. Postoperative GFR of the operated kidney was the independent predictor of GFR of contralateral kidney (p = 0.001). Tumor diameter (p = 0.036), age (p = 0.005), and postoperative GFR of the contralateral kidney (p = 0.001) were all independent predictors of postoperative GFR of the operated kidney. ΔGFR1 was the independent predictor of ΔGFR2. Results showed that a more pronounced postoperative decline in GFR on the operated side corresponded to a weaker compensatory capacity of the contralateral-side kidney.

Conclusions

During the course of the surgical procedure, the active endeavor to safeguard the renal function of the operated kidney side holds paramount importance, which yields positive outcomes for postoperative kidney function on the contralateral side, consequently contributing to the overall preservation of renal function.

中文翻译：

局限性肾癌肾部分切除术后双侧 GFR 的相关性

客观的

探讨局限性肾细胞癌（RCC）患者肾部分切除术（PN）后术侧残余肾小球滤过率（GFR）与对侧肾小球滤过率（GFR）之间的关系。

材料和方法

经机构审查委员会批准后，我们对 2018 年 5 月至 2023 年 7 月的临床记录进行了回顾性分析，涉及 118 名因单侧局限性肾肿瘤（T1-T2）接受肾部分切除术的患者。使用单光子发射计算机断层扫描 ( SPECT )/计算机断层扫描成像[使用 9mTc-DTPA（二乙烯三胺五乙酸）肾脏动态成像]评估肾小球滤过率数据。使用线性回归分析确定术后肾功能或肾功能变化的独立决定因素。此外，还收集了患者的人口统计学、临床和肾测量特征。

结果

最终共有58名患者入组。术前、术后双肾GFR呈显着正相关。手术肾脏的术后 GFR 是对侧肾脏 GFR 的独立预测因子 ( p = 0.001)。肿瘤直径 ( p = 0.036)、年龄 ( p = 0.005) 和对侧肾脏术后 GFR ( p = 0.001) 都是手术肾脏术后 GFR 的独立预测因素。 ΔGFR1 是 ΔGFR2 的独立预测因子。结果显示，手术侧肾小球滤过率（GFR）术后下降更明显，对应对侧肾脏代偿能力较弱。