To investigate whether post-operative complications may affect long-term functional outcomes of renal patients treated with nephron sparing surgery (NSS).
We performed an observational study enrolling 596 patients with pre-operative normal renal function treated with NSS for clinical T1abN0M0 renal mass. Cox regression models estimated hazard ratios (HR) and 95% confidence intervals (CI) for CKD including as covariates age, comorbidity (scored as for the Charlson comorbidity index), hypertension, tumor size, pre-operative eGFR, eGFR<60 ml/min/1.73m2 at discharge, and ischemia time.
Of all, 137 (23%) patients developed post-operative complications. At a median follow-up of 53 (26-91) months, CKD risk was 19% for patients with post-operative complications and 11% for those without complications. Patients experiencing post-operative complications (HR 1.90, 95% CI 1.26-2.86) were at increased risk of developing CKD during the follow up at multivariable analysis, after accounting for confounders.
Our data outline how post-operative complications might have a detrimental impact on post-operative renal function in patients submitted to NSS. Improper patient selection, increasing the risk of post-operative complications, could limit the benefit in terms of renal function brought by NSS. This article is protected by copyright. All rights reserved.
BJU international. 2019 Feb 15 [Epub ahead of print]
Eugenio Ventimiglia, Alessandro Larcher, Francesco Trevisani, Fabio Muttin, Francesco Cianflone, Francesco Montorsi, Andrea Salonia, Roberto Bertini, Umberto Capitanio
Università Vita-Salute San Raffaele, Milan, Italy.