Preoperative CT volumetry of estimated residual kidney for prediction of postoperative chronic kidney disease in patient
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ORIGINAL ARTICLE
Preoperative CT volumetry of estimated residual kidney for prediction of postoperative chronic kidney disease in patients with renal cell carcinoma Yutaro Hori1 · Daisuke Obinata1 · Daigo Funakoshi1 · Fuminori Sakurai1 · Tsuyoshi Yoshizawa1 · Tsuyoshi Matsui1 · Junichi Mochida1 · Kenya Yamaguchi1 · Satoru Takahashi1 Received: 7 May 2020 / Accepted: 6 October 2020 © Japanese Society of Nephrology 2020
Abstract Background Surgical treatments for renal cell carcinoma reduces kidney volume to some degree and may derive postsurgical chronic kidney disease. We made a new marker for postoperative renal function using CT volumetry. To determine the impact of various parameters including this marker, we observed pre- and postsurgical renal function of experienced cases. Methods From 2004 to 2014, we underwent total or partial nephrectomy for 181 patients with renal carcinoma in a single institution. Of the total, 138 cases with presurgical CT volumetry were included in this study. We evaluated parameters for assessments of peri- and postoperative renal function including age, gender, serum creatinine, eGFR, performed surgery, pathology, estimated residual kidney volume and associated disease. Presence or absence of acute kidney injury (AKI) and chronic kidney disease (CKD) were also evaluated before, immediately after and 5 years after surgery. Results Multiple logistic regression analysis identified AKI, preoperative eGFR and estimated residual kidney volume as significant prognostic factors for the postoperative CKD. Moreover, cases with triple positive of these factors suffer postoperative CKD more significantly than those with one or two positives. Conclusion Using these predictive factors, we may determine patients with high risk for CKD who require an early intervention of renal protective treatment. Keywords Renal cell carcinoma · Nephrectomy · Acute kidney insufficiency · Chronic kidney disease · Volumetry
Introduction Renal cell carcinoma is the most frequent cancer in kidneys. In addition, the incidence of renal cancer and renal pelvis cancer in Japan is increasing [1]. This increase partly dues to Abstract of this work has been partly presented at the annual meeting of the American Urological Association (AUA) in 2019. Yutaro Hori and Daisuke Obinata contributed equally. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10157-020-01984-8) contains supplementary material, which is available to authorized users. * Kenya Yamaguchi yamaguchi.kenya@nihon‑u.ac.jp 1
Department of Urology, Nihon University School of Medicine, 30‑1, Oyaguchikamicho, Itabashi‑ku, Tokyo 173‑8610, Japan
the development of diagnostic tools at an early stage such as CT and echo [2]. Surgical treatment is an essential treatment for renal cancer. Colombo et al. reported that recurrence-free survival at 7 years from radical nephrectomy was around 90% [3]. Furthermore, surgical therapies showed favorable result in the cases with metastatic renal cell carcinoma [4]. Ho
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