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Preoperative CT volumetry of estimated residual kidney for prediction of postoperative chronic kidney disease in patients with renal cell carcinoma

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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.

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Author information

Author notes

  1. Yutaro Hori and Daisuke Obinata contributed equally.

Authors and Affiliations

  1. Department of Urology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan

    Yutaro Hori, Daisuke Obinata, Daigo Funakoshi, Fuminori Sakurai, Tsuyoshi Yoshizawa, Tsuyoshi Matsui, Junichi Mochida, Kenya Yamaguchi & Satoru Takahashi

Authors
  1. Yutaro Hori
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  2. Daisuke Obinata
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  3. Daigo Funakoshi
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  4. Fuminori Sakurai
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  5. Tsuyoshi Yoshizawa
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  6. Tsuyoshi Matsui
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  7. Junichi Mochida
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  8. Kenya Yamaguchi
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  9. Satoru Takahashi
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Corresponding author

Correspondence to Kenya Yamaguchi.

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Conflict of interest

The authors have declared that no conflict of interest exists.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (IRB approval number RK-170711-7) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Electronic supplementary material

Supp Fig 1. The association of age and eGFR at each time (before: A, 6 months: B, 12 months: C, 36 months: and D, 60 months: E after surgery).

10157_2020_1984_MOESM1_ESM.jpg

Supp Fig 1 The association of age and eGFR at each time (before: A, 6 months: B, 12 months: C, 36 months: and D, 60 months: E after surgery) (JPG 949 kb)

Supp Fig 2. ROC curves for estimated residual kidney volume (A), eGFR (B), and Age (C) to predict CKD development.

10157_2020_1984_MOESM2_ESM.jpg

Supp Fig 2 ROC curves for estimated residual kidney volume (A), eGFR (B), and Age (C) to predict CKD development (JPG 836 kb)

Supp Fig 3. The association of renal ischemic time with AKI after the surgery (A), CKD development (B), and eGFR after 6 months the surgery (C).

10157_2020_1984_MOESM3_ESM.jpg

Supp Fig 3 The association of renal ischemic time with AKI after the surgery (A), CKD development (B), and eGFR after 6 months the surgery (C) (JPG 623 kb)

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Hori, Y., Obinata, D., Funakoshi, D. et al. Preoperative CT volumetry of estimated residual kidney for prediction of postoperative chronic kidney disease in patients with renal cell carcinoma. Clin Exp Nephrol 25, 315–321 (2021). https://doi.org/10.1007/s10157-020-01984-8

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  • DOI: https://doi.org/10.1007/s10157-020-01984-8

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