Video Lectures
State-of-the-industry video lectures by leading urology experts
Latest Videos

TAIPEI, TAIWAN (UroToday.com) - Introduction and Objectives: The most important modifiable risk factors for kidney function after partial nephrectomy (PN) are the quantity of parenchyma removed and the length of warm ischemia time (WIT). In this study, we further investigate the effects of WIT on renal function by comparing PN patients to completely healthy patients undergoing total donor nephrectomy (DN).

wceMethods: We performed a retrospective review of 92 PN and 242 DN patients at a single academic institution. Baseline characteristics, WIT, and follow-up serum Creatinine (sCr) at discharge, 1–7 months and at last follow-up were compared. Estimated GFR (eGFR) was calculated using sCr and the Modification of Diet on Renal Disease (MDRD) formula. Data was analyzed using the Mann-Whitney U and Chi-square tests as appropriate.

Results: The DN patients were younger (37.4 vs. 60.2; p < 0.001), and had lower EBL(103.0 vs. 287.9; p < 0.001), BMI(26.5 vs. 30.8; p < 0.001), and ASA(1 vs. 2.7; p < 0.001). They were also less likely to require transfusions intraoperatively (p = 0.001) and had higher preoperative eGFR(101.6 vs. 78.1; p < 0.001). In the PN cohort, the median tumor size was 3.2 cm and mean WIT was 27.9 minutes. DN patients were found to have greater eGFR decline upon discharge ( - 46.7% vs. - 4.2%, p < 0.001), at 1–7 month postoperatively ( - 36.9% vs. - 5.5%; p < 0.001) and at the latest follow-up ( - 38.0% vs. - 2.4%; p < 0.001).

Conclusions: In the PN cohort, warm ischemia in patients with greater medical comorbidity resulted in much less decrease in GFR than a total nephrectomy performed in a completely healthy donor population. The primary concern for surgeons performing partial nephrectomy should be renal preservation not warm ischemia time.

Source of Funding: None

 
Listen to an interview with Javier Arenas, one of the authors of this study.

 

Presented by Daniel Faaborg, Roger Li, Herbert C. Ruckle, Jared Schober, Michelle Lightfoot, Muhannad Alsyouf, Phillip Stokes, David Culpepper, David Tryon, Gene O. Huang, Javier Arenas, and D. Duane Baldwin at the 32nd World Congress of Endourology & SWL- September 3 - 7, 2014 - Taipei, Taiwan

Loma Linda University Medical Center, Loma Linda, CA USA 

 

Calendar
Upcoming urology industry events
August 1-5, 2018 / Sheraton Philadelphia Society Hill Hotel
SUFU Research Foundation Resident Preceptorship 2018
August 3-4, 2018 / Hyatt Regency Washington on Capitol Hill
Best of ASCO 2018 - Washington, DC
August 10-11, 2018 / The Palmer House Hilton, Chicago, IL
Best of ASCO 2018 - Chicago, IL
August 28-31, 2018 / ICS 2018
International Continence Society 2018
Journals
Print publications focusing on urological cancer treatments through original commentary & articles
Everyday Urology Volume 2 Issue 4

Everyday Urology™ - Oncology Insights

From the Editor

PCAN cover

Prostate Cancer and Prostatic Diseases

From the Editor