Impact of tumour morphology on renal function decline after partial nephrectomy

Reza Mehrazin, Kerrin L. Palazzi, Ryan Kopp, Caroline J. Colangelo, Sean P. Stroup, James H. Masterson, Michael A. Liss, Seth A. Cohen, Ramzi Jabaji, Samuel K. Park, Anthony L. Patterson, James O. L'Esperance, Ithaar H. Derweesh

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objective To examine the association of renal morphology with renal function after partial nephrectomy (PN). Patients and Methods We conducted a multi-institutional retrospective analysis of 322 PNs performed between 2003 and 2011. The RENAL nephrometry score for each lesion was determined and the estimated glomerular filtration rate (eGFR) was calculated preoperatively and at last follow-up. We divided patients into two RENAL nephrometry score groups, low (2 at last follow-up. Multivariable analysis was conducted to evaluate the risk factors for eGFR 2 at last follow-up. Results The median (interquartile range) follow-up was 25.2 (13.5-39.3) months. Low (n = 165) and high (n = 157) RENAL score groups were well-matched for baseline eGFR. The median tumour size (4.2 vs 2.4 cm, P <0.001) was greater for the high group. In all, 64% of the low and 88.2% of the high RENAL score group (P <0.001) had decreased eGFR at last follow-up. Median eGFR was -7 for the low vs -13.8 mL/min/1.73 m2 for the high group (P = 0.001); eGFR 2 at last follow-up was 27.3% for the low vs 37.6% for the high group (P = 0.057). Linear regression analysis showed that for each 1-point increase in RENAL score, there was 2.5% decrease in eGFR (P = 0.002); for each 1-cm increase in tumour size, there was 1.8% decrease in eGFR (P = 0.013). Area under curve analyses showed no significant difference between RENAL score and tumour size for prediction of de novoâ€...eGFR 2 (P = 0.920) and ΔeGFR ≥50% (P = 0.85). Multivariable analysis showed that increasing RENAL score (odds ratio [OR] 1.24, P = 0.046) and decreasing preoperative eGFR (OR 1.10, P <0.001) were risk factors for eGFR 2 at last follow-up. Conclusions Increasing RENAL nephrometry score is an independent risk factor for eGFR 2 after PN. RENAL nephrometry score may serve as an additional measure for risk stratification before PN, but further investigation is required.

Original languageEnglish (US)
JournalBJU International
Volume111
Issue number8
DOIs
StatePublished - Jun 2013
Externally publishedYes

Fingerprint

Nephrectomy
Glomerular Filtration Rate
Kidney
Neoplasms
Odds Ratio
Area Under Curve
Linear Models
Regression Analysis

Keywords

  • chronic kidney disease
  • chronic renal insufficiency
  • glomerular filtration rate
  • nephron-sparing surgery
  • partial nephrectomy
  • renal cell carcinoma
  • renal function
  • RENAL nephrometry score

ASJC Scopus subject areas

  • Urology

Cite this

Mehrazin, R., Palazzi, K. L., Kopp, R., Colangelo, C. J., Stroup, S. P., Masterson, J. H., ... Derweesh, I. H. (2013). Impact of tumour morphology on renal function decline after partial nephrectomy. BJU International, 111(8). https://doi.org/10.1111/bju.12149

Impact of tumour morphology on renal function decline after partial nephrectomy. / Mehrazin, Reza; Palazzi, Kerrin L.; Kopp, Ryan; Colangelo, Caroline J.; Stroup, Sean P.; Masterson, James H.; Liss, Michael A.; Cohen, Seth A.; Jabaji, Ramzi; Park, Samuel K.; Patterson, Anthony L.; L'Esperance, James O.; Derweesh, Ithaar H.

In: BJU International, Vol. 111, No. 8, 06.2013.

Research output: Contribution to journalArticle

Mehrazin, R, Palazzi, KL, Kopp, R, Colangelo, CJ, Stroup, SP, Masterson, JH, Liss, MA, Cohen, SA, Jabaji, R, Park, SK, Patterson, AL, L'Esperance, JO & Derweesh, IH 2013, 'Impact of tumour morphology on renal function decline after partial nephrectomy', BJU International, vol. 111, no. 8. https://doi.org/10.1111/bju.12149
Mehrazin, Reza ; Palazzi, Kerrin L. ; Kopp, Ryan ; Colangelo, Caroline J. ; Stroup, Sean P. ; Masterson, James H. ; Liss, Michael A. ; Cohen, Seth A. ; Jabaji, Ramzi ; Park, Samuel K. ; Patterson, Anthony L. ; L'Esperance, James O. ; Derweesh, Ithaar H. / Impact of tumour morphology on renal function decline after partial nephrectomy. In: BJU International. 2013 ; Vol. 111, No. 8.
@article{8a02a0622e6c44e88f3ec91874b33b82,
title = "Impact of tumour morphology on renal function decline after partial nephrectomy",
abstract = "Objective To examine the association of renal morphology with renal function after partial nephrectomy (PN). Patients and Methods We conducted a multi-institutional retrospective analysis of 322 PNs performed between 2003 and 2011. The RENAL nephrometry score for each lesion was determined and the estimated glomerular filtration rate (eGFR) was calculated preoperatively and at last follow-up. We divided patients into two RENAL nephrometry score groups, low (2 at last follow-up. Multivariable analysis was conducted to evaluate the risk factors for eGFR 2 at last follow-up. Results The median (interquartile range) follow-up was 25.2 (13.5-39.3) months. Low (n = 165) and high (n = 157) RENAL score groups were well-matched for baseline eGFR. The median tumour size (4.2 vs 2.4 cm, P <0.001) was greater for the high group. In all, 64{\%} of the low and 88.2{\%} of the high RENAL score group (P <0.001) had decreased eGFR at last follow-up. Median eGFR was -7 for the low vs -13.8 mL/min/1.73 m2 for the high group (P = 0.001); eGFR 2 at last follow-up was 27.3{\%} for the low vs 37.6{\%} for the high group (P = 0.057). Linear regression analysis showed that for each 1-point increase in RENAL score, there was 2.5{\%} decrease in eGFR (P = 0.002); for each 1-cm increase in tumour size, there was 1.8{\%} decrease in eGFR (P = 0.013). Area under curve analyses showed no significant difference between RENAL score and tumour size for prediction of de novo{\^a}€...eGFR 2 (P = 0.920) and ΔeGFR ≥50{\%} (P = 0.85). Multivariable analysis showed that increasing RENAL score (odds ratio [OR] 1.24, P = 0.046) and decreasing preoperative eGFR (OR 1.10, P <0.001) were risk factors for eGFR 2 at last follow-up. Conclusions Increasing RENAL nephrometry score is an independent risk factor for eGFR 2 after PN. RENAL nephrometry score may serve as an additional measure for risk stratification before PN, but further investigation is required.",
keywords = "chronic kidney disease, chronic renal insufficiency, glomerular filtration rate, nephron-sparing surgery, partial nephrectomy, renal cell carcinoma, renal function, RENAL nephrometry score",
author = "Reza Mehrazin and Palazzi, {Kerrin L.} and Ryan Kopp and Colangelo, {Caroline J.} and Stroup, {Sean P.} and Masterson, {James H.} and Liss, {Michael A.} and Cohen, {Seth A.} and Ramzi Jabaji and Park, {Samuel K.} and Patterson, {Anthony L.} and L'Esperance, {James O.} and Derweesh, {Ithaar H.}",
year = "2013",
month = "6",
doi = "10.1111/bju.12149",
language = "English (US)",
volume = "111",
journal = "BJU International",
issn = "1464-4096",
publisher = "Wiley-Blackwell",
number = "8",

}

TY - JOUR

T1 - Impact of tumour morphology on renal function decline after partial nephrectomy

AU - Mehrazin, Reza

AU - Palazzi, Kerrin L.

AU - Kopp, Ryan

AU - Colangelo, Caroline J.

AU - Stroup, Sean P.

AU - Masterson, James H.

AU - Liss, Michael A.

AU - Cohen, Seth A.

AU - Jabaji, Ramzi

AU - Park, Samuel K.

AU - Patterson, Anthony L.

AU - L'Esperance, James O.

AU - Derweesh, Ithaar H.

PY - 2013/6

Y1 - 2013/6

N2 - Objective To examine the association of renal morphology with renal function after partial nephrectomy (PN). Patients and Methods We conducted a multi-institutional retrospective analysis of 322 PNs performed between 2003 and 2011. The RENAL nephrometry score for each lesion was determined and the estimated glomerular filtration rate (eGFR) was calculated preoperatively and at last follow-up. We divided patients into two RENAL nephrometry score groups, low (2 at last follow-up. Multivariable analysis was conducted to evaluate the risk factors for eGFR 2 at last follow-up. Results The median (interquartile range) follow-up was 25.2 (13.5-39.3) months. Low (n = 165) and high (n = 157) RENAL score groups were well-matched for baseline eGFR. The median tumour size (4.2 vs 2.4 cm, P <0.001) was greater for the high group. In all, 64% of the low and 88.2% of the high RENAL score group (P <0.001) had decreased eGFR at last follow-up. Median eGFR was -7 for the low vs -13.8 mL/min/1.73 m2 for the high group (P = 0.001); eGFR 2 at last follow-up was 27.3% for the low vs 37.6% for the high group (P = 0.057). Linear regression analysis showed that for each 1-point increase in RENAL score, there was 2.5% decrease in eGFR (P = 0.002); for each 1-cm increase in tumour size, there was 1.8% decrease in eGFR (P = 0.013). Area under curve analyses showed no significant difference between RENAL score and tumour size for prediction of de novoâ€...eGFR 2 (P = 0.920) and ΔeGFR ≥50% (P = 0.85). Multivariable analysis showed that increasing RENAL score (odds ratio [OR] 1.24, P = 0.046) and decreasing preoperative eGFR (OR 1.10, P <0.001) were risk factors for eGFR 2 at last follow-up. Conclusions Increasing RENAL nephrometry score is an independent risk factor for eGFR 2 after PN. RENAL nephrometry score may serve as an additional measure for risk stratification before PN, but further investigation is required.

AB - Objective To examine the association of renal morphology with renal function after partial nephrectomy (PN). Patients and Methods We conducted a multi-institutional retrospective analysis of 322 PNs performed between 2003 and 2011. The RENAL nephrometry score for each lesion was determined and the estimated glomerular filtration rate (eGFR) was calculated preoperatively and at last follow-up. We divided patients into two RENAL nephrometry score groups, low (2 at last follow-up. Multivariable analysis was conducted to evaluate the risk factors for eGFR 2 at last follow-up. Results The median (interquartile range) follow-up was 25.2 (13.5-39.3) months. Low (n = 165) and high (n = 157) RENAL score groups were well-matched for baseline eGFR. The median tumour size (4.2 vs 2.4 cm, P <0.001) was greater for the high group. In all, 64% of the low and 88.2% of the high RENAL score group (P <0.001) had decreased eGFR at last follow-up. Median eGFR was -7 for the low vs -13.8 mL/min/1.73 m2 for the high group (P = 0.001); eGFR 2 at last follow-up was 27.3% for the low vs 37.6% for the high group (P = 0.057). Linear regression analysis showed that for each 1-point increase in RENAL score, there was 2.5% decrease in eGFR (P = 0.002); for each 1-cm increase in tumour size, there was 1.8% decrease in eGFR (P = 0.013). Area under curve analyses showed no significant difference between RENAL score and tumour size for prediction of de novoâ€...eGFR 2 (P = 0.920) and ΔeGFR ≥50% (P = 0.85). Multivariable analysis showed that increasing RENAL score (odds ratio [OR] 1.24, P = 0.046) and decreasing preoperative eGFR (OR 1.10, P <0.001) were risk factors for eGFR 2 at last follow-up. Conclusions Increasing RENAL nephrometry score is an independent risk factor for eGFR 2 after PN. RENAL nephrometry score may serve as an additional measure for risk stratification before PN, but further investigation is required.

KW - chronic kidney disease

KW - chronic renal insufficiency

KW - glomerular filtration rate

KW - nephron-sparing surgery

KW - partial nephrectomy

KW - renal cell carcinoma

KW - renal function

KW - RENAL nephrometry score

UR - http://www.scopus.com/inward/record.url?scp=84878337280&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878337280&partnerID=8YFLogxK

U2 - 10.1111/bju.12149

DO - 10.1111/bju.12149

M3 - Article

VL - 111

JO - BJU International

JF - BJU International

SN - 1464-4096

IS - 8

ER -