Hypertension (HTN) is a global public health issue. There are limited data regarding the effects of HTN in patients undergoing partial nephrectomy (PN) for renal tumors. To address this void, we tested the association between HTN and renal function after minimally invasive PN (MIPN).
Using a multi-institutional database (2007-2017), we identified patients aged ≥ 18 years with a diagnosis of cT1 renal tumors treated with MIPN. Kaplan-Meier plots and Cox regression models addressed newly-onset CKD stage ≥ 3b or higher (sCKD). All analyses were repeated after 1:1 propensity score matching (PSM).
Overall, 2144 patients were identified. Of those, 35% (n = 759) were yes-HTN. Yes-HTN patients were older, more frequently male and more often presented with diabetes. Yes-HTN patients harbored higher RENAL nephrometry scores and higher cT stages than no-HTN patients. Conversely, yes-HTN patients exhibited lower preoperative eGFRs. In the overall cohort, five-year sCKD-free survival was 86% vs. 94% for yes-HTN vs. no-HTN, which translated into a multivariable HR of 1.67 (95% CI: 1.06-2.63, p = 0.026). After 1:1 PSM, virtually the same results were observed (HR 1.86, 95% CI: 1.07-3.23, p = 0.027).
Yes-HTN patients exhibited worse renal function after MIPN when compared to their no-HTN counterparts. However, these observations need to be further tested in a prospective cohort study.
Journal of clinical medicine. 2022 Feb 25*** epublish ***
Rocco Simone Flammia, Umberto Anceschi, Antonio Tufano, Gabriele Tuderti, Maria Consiglia Ferriero, Aldo Brassetti, Andrea Mari, Fabrizio Di Maida, Andrea Minervini, Ithaar H Derweesh, Umberto Capitanio, Alessandro Larcher, Francesco Montorsi, Daniel D Eun, Jennifer Lee, Lorenzo G Luciani, Tommaso Cai, Gianni Malossini, Alessandro Veccia, Riccardo Autorino, Cristian Fiori, Francesco Porpiglia, Michele Gallucci, Costantino Leonardo, Giuseppe Simone
Urology Unit, Department of Maternal-Child and Urological Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, 00162 Rome, Italy., Department of Urologic Oncology, IRCCS "Regina Elena" National Cancer Institute, 00144 Rome, Italy., Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, 50134 Florence, Italy., Department of Urology, UC San Diego School (UCSD), San Diego, CA 92103, USA., Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA., Department of Urology, Santa Chiara Regional Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), 38122 Trento, Italy., Division of Urology, Virginia Commonwealth University, Richmond, VA 23298, USA., Department of Urology, San Luigi Gonzaga Hospital, University of Turin, 10043 Orbassano, Italy.