The Pre-operative Clinical Predictors for Renal Insufficiency Developing after Radical Nephrectomy in the Patients with Contralateral Normal Kidney / 대한비뇨기과학회지
Korean Journal of Urology
;
: 645-650, 2002.
Article
Dans Coréen
| WPRIM
| ID: wpr-136474
ABSTRACT
PURPOSE:
In order to help selecting candidates for nephron-sparing surgery, the pre-operative clinical parameters that can predict a renal insufficiency developing after a radical nephrectomy even in patients with contralateral normal kidney were identified. MATERIALS ANDMETHODS:
Of 551 patients who underwent a radical nephrectomy to treat a renal cell carcinoma, 213 patients with a pre-operative serum creatinine >2.0mg/dl or with synchronous bilateral or metastatic tumors were excluded. In 338 patients (male 227, female 111), the incidence of post-operative renal insufficiency was evaluated. Using Kaplan-Meier's method, the clinical parameters including age, sex, pre-operative serum creatinine level, hypertension and diabetes mellitus were evaluated to determine if they could be used to predict a post-nephrectomy creatinine failure, which was defined as a serum creatinine >2.0mg/dl.RESULTS:
Of the 338 patients, creatinine failure had developed in 25 (6.1%) at post-operative 8 months (1-72 months). The mean pre-operative serum creatinine level of these patients was 1.35mg/dl. Six patients were older than 60, 16 patients had hypertensive and 8 patients were diabetic. In 2 patients, hemodialysis was required due to a progressive post-operative deterioration in the renal function. Multivariate analysis revealed that all the pre-operative clinical parameters such as old age (>60 years), male sexuality, hypertension, diabetes mellitus and an elevated serum creatinine level (>1.4mg/dl) were significant independent predictors of a post-nephrectomy renal insufficiency (p< 0.05).CONCLUSIONS:
Patients with clinical factors including old age, male sexuality, hypertension, diabetes mellitus and an elevated creatinine value have an increased risk of a renal insufficiency after a radical nephrectomy even though the contralateral kidney is normal. Therefore, in these patients nephron-sparing surgery is strongly recommended.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Néphrocarcinome
/
Incidence
/
Analyse multifactorielle
/
Dialyse rénale
/
Sexualité
/
Créatinine
/
Diabète
/
Insuffisance rénale
/
Hypertension artérielle
/
Rein
Type d'étude:
Etude d'incidence
/
Étude pronostique
Limites du sujet:
Femelle
/
Humains
/
Mâle
langue:
Coréen
Texte intégral:
Korean Journal of Urology
Année:
2002
Type:
Article
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