Follow-up study of unilateral renal function after nephrectomy assessed by glomerular filtration rate per functional ren
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WORLD JOURNAL OF SURGICAL ONCOLOGY
RESEARCH
Open Access
Follow-up study of unilateral renal function after nephrectomy assessed by glomerular filtration rate per functional renal volume Yukinari Hosokawa1*, Nobumichi Tanaka2, Hisakazu Mibu2, Satoshi Anai2, Kazumasa Torimoto2, Tatsuo Yoneda2, Akihide Hirayama2, Katsunori Yoshida2, Yoshiki Hayashi1, Yoshihiko Hirao2 and Kiyohide Fujimoto2
Abstract Background: To evaluate the clinical usefulness of estimated glomerular filtration rate (eGFR) divided by functional renal volume (FRV) measured by three-dimensional image reconstruction (eGFR/FRV) for the prediction of functional outcomes after nephrectomy. Methods: Eighty-three patients who underwent nephrectomy were enrolled. The FRV of each patient was measured before surgery. Preoperative medical information on proteinuria, blood pressure, blood glucose level, body mass index (BMI), hemoglobin level and serum cholesterol level were also obtained. We evaluated the relationships between eGFR/FRV and each of these parameters before surgery. We also assessed the potential relationship between eGFR/FRV and the 3-year postoperative eGFR. Stepwise multiple regression analyses were conducted to elucidate independent factors. Results: The median FRV and eGFR were 310.15 cm3 and 79.0 ml/min/1.73 m2 before surgery, respectively. The correlation between FRV and eGFR was statistically significant (r = 0.465, P < 0.001). The median eGFR/FRV was 0.24 ml/min/1.73 m2/cm3. Stepwise multiple regression analysis showed that the independent parameters (multiple correlation coefficient, r = 0.389, P = 0.031) associated with eGFR/FRV were proteinuria, BMI, age and hypertension. Proteinuria was statistically associated with eGFR/FRV, and the independent parameters (multiple correlation coefficient, r = 0.694, P < 0.001) associated with the 3-year postoperative eGFR were age, BMI and eGFR/FRV. The eGFR/FRV was statistically associated with the 3-year postoperative eGFR (r = 0.559, P < 0.001). Conclusion: The present results demonstrated that patients with proteinuria are expected to have a lower eGFR/FRV than those without proteinuria. The present study also supports the notion that eGFR/FRV is the primary determinant of the long-term functional outcome after nephrectomy. It should be taken into consideration that patients with a low eGFR/FRV may develop chronic kidney disease after nephrectomy. Keywords: Functional renal parenchymal volume, eGFR, Proteinuria, Renal surgery
Background Most patients who are newly diagnosed with renal cell carcinoma (RCC) are usually treated surgically. Recently, nephron sparing surgery (NSS) is considered to be as curative for early stage RCC as radical nephrectomy (RN) [1] and is becoming a standard therapy for small RCC. Several groups have reported that RN increases * Correspondence: [email protected] 1 Department of Urology, Tane General Hospital, 1-12-21 Kujyominami Nishi-ku, Osaka, Osaka 550-0025, Japan Full list of author information is available at the end of the article
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