TY - JOUR
T1 - Comparison of rates and risk factors for development of anaemia and erythropoiesis-stimulating agent utilization after radical or partial nephrectomy
AU - Woldrich, Jeffrey
AU - Mehrazin, Reza
AU - Bazzi, Wassim M.
AU - Bagrodia, Aditya
AU - Kopp, Ryan P.
AU - Malcolm, John B.
AU - Kane, Christopher J.
AU - Patterson, Anthony L.
AU - Wan, Jim Y.
AU - Derweesh, Ithaar H.
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2012/4
Y1 - 2012/4
N2 - Objective To examine the incidence of and risk factors for the development of anaemia and erythropoiesis-stimulation agent (ESA) treatment in patients undergoing radical nephrectomy (RN) and partial nephrectomy (PN) because anaemia is a significant cause of morbidity in chronic kidney disease. Patients and Methods The study comprised a retrospective review of 905 patients (610 RN/295 PN; mean age, 57.5 years; mean follow-up, 6.4 years) who underwent surgery for renal tumours at two institutions from July 1987 to June 2007. Demographics, disease characteristics and pre- and postoperative (i.e. renal function, metabolic parameters, anaemia and ESA treatment) were recorded. Data were analyzed within subgroups based on treatment (RN vs PN). Multivariate analysis was conducted to determine the risk factors for developing anaemia after surgery. Results Tumour size (cm) was significantly larger for RN (RN 7.0 vs PN 3.7; P < 0.001). No significant differences were noted with respect to demographics and preoperative anaemia (RN 16.4% vs PN 18.6%; P= 0.454) and ESA-treatment (RN 0.7% vs PN 1.4%; P= 0.499). After surgery, significantly less de novo anaemia (PN 4.1% vs RN 17.5%; P < 0.001) and ESA utilization (PN 2.7% vs RN 13.4%; P < 0.001) occurred in the PN cohort. Multivariate analysis showed that age ≤60 years (odds ratio, OR, 1.62; P= 0.008), African American ethnicity (OR, 2.30; P < 0.001), smoking (OR, 1.60; P= 0.013), glomerular filtration rate (GFR) <60 mL/min/1.73 m 2 (OR, 4.09; P < 0.001), ≤1+ proteinuria (OR, 2.19; P < 0.03), metabolic acidosis (OR, 4.08; P= 0.007) and RN (OR, 2.58; P < 0.001) were significantly associated with de novo anaemia. Conclusions Patients who underwent RN had a significantly higher prevalence of anaemia and ESA-treatment compared to a well-matched cohort that underwent PN. In addition to RN, age ≤60 years, African American ethnicity, history of smoking, GFR < 60 mL/min/1.73 m 2, proteinuria and metabolic acidosis were associated with developing anaemia.
AB - Objective To examine the incidence of and risk factors for the development of anaemia and erythropoiesis-stimulation agent (ESA) treatment in patients undergoing radical nephrectomy (RN) and partial nephrectomy (PN) because anaemia is a significant cause of morbidity in chronic kidney disease. Patients and Methods The study comprised a retrospective review of 905 patients (610 RN/295 PN; mean age, 57.5 years; mean follow-up, 6.4 years) who underwent surgery for renal tumours at two institutions from July 1987 to June 2007. Demographics, disease characteristics and pre- and postoperative (i.e. renal function, metabolic parameters, anaemia and ESA treatment) were recorded. Data were analyzed within subgroups based on treatment (RN vs PN). Multivariate analysis was conducted to determine the risk factors for developing anaemia after surgery. Results Tumour size (cm) was significantly larger for RN (RN 7.0 vs PN 3.7; P < 0.001). No significant differences were noted with respect to demographics and preoperative anaemia (RN 16.4% vs PN 18.6%; P= 0.454) and ESA-treatment (RN 0.7% vs PN 1.4%; P= 0.499). After surgery, significantly less de novo anaemia (PN 4.1% vs RN 17.5%; P < 0.001) and ESA utilization (PN 2.7% vs RN 13.4%; P < 0.001) occurred in the PN cohort. Multivariate analysis showed that age ≤60 years (odds ratio, OR, 1.62; P= 0.008), African American ethnicity (OR, 2.30; P < 0.001), smoking (OR, 1.60; P= 0.013), glomerular filtration rate (GFR) <60 mL/min/1.73 m 2 (OR, 4.09; P < 0.001), ≤1+ proteinuria (OR, 2.19; P < 0.03), metabolic acidosis (OR, 4.08; P= 0.007) and RN (OR, 2.58; P < 0.001) were significantly associated with de novo anaemia. Conclusions Patients who underwent RN had a significantly higher prevalence of anaemia and ESA-treatment compared to a well-matched cohort that underwent PN. In addition to RN, age ≤60 years, African American ethnicity, history of smoking, GFR < 60 mL/min/1.73 m 2, proteinuria and metabolic acidosis were associated with developing anaemia.
KW - anaemia
KW - erythropoiesis-stimulating agent
KW - nephron-sparing surgery
KW - partial nephrectomy
KW - radical nephrectomy
KW - renal cell carcinoma
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U2 - 10.1111/j.1464-410X.2011.10432.x
DO - 10.1111/j.1464-410X.2011.10432.x
M3 - Review article
C2 - 21933323
AN - SCOPUS:84858446795
SN - 1464-4096
VL - 109
SP - 1019
EP - 1025
JO - BJU international
JF - BJU international
IS - 7
ER -