Washington, DC (UroToday.com) In the SUO meeting poster session Zhiling Zhang and colleagues from the Cleveland Clinic presented their data on acute kidney injury after partial nephrectomy. Acute increase in serum creatinine (sCr) after partial nephrectomy (PN) is primarily due to parenchymal mass reduction or ischemia, however only ischemia can impact subsequent functional recovery. The authors evaluated etiologies of acute kidney injury (AKI) after PN and
their prognostic significance. 83 solitary kidneys managed with PN were evaluated. AKI was classified by either preoperative sCr or parenchymal mass reduction. Recovery was defined as percent function preserved normalized by percent mass saved. Predictive factors for AKI were evaluated by regression analysis. Median duration of warm ischemia was 20 minutes and hypothermia 29 minutes. Median parenchymal mass reduction was 11%. On multivariate analysis, only ischemia time correlated with AKI (p=0.007). Median recovery from ischemia was 99% for patients without AKI and 95%, 90%, 88% for patients with grade 1, 2, 3 AKI respectively. The authors concluded that parenchymal mass reduction and ischemia both contribute to AKI after PN, however, only AKI correlates with subsequent functional recovery. While AKI is associated with suboptimal recovery, even patients with grade 2/3 AKI reached 88-90% of recovery expected.
The Cleveland Clinic
Dr. Miki Haifler, MD. from the Society of Urologic Oncology Meeting - December 2 - 4, 2015 – Washington, DC.
Fox Chase Cancer Center, Philadelphia, PA.