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.
Artigo
em Coreano
| WPRIM
| ID: wpr-136475
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.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Carcinoma de Células Renais
/
Incidência
/
Análise Multivariada
/
Diálise Renal
/
Sexualidade
/
Creatinina
/
Diabetes Mellitus
/
Insuficiência Renal
/
Hipertensão
/
Rim
Tipo de estudo:
Estudo de incidência
/
Estudo prognóstico
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Coreano
Revista:
Korean Journal of Urology
Ano de publicação:
2002
Tipo de documento:
Artigo
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