SAN DIEGO, CA USA (UroToday.com) - The relationship between lipid metabolism and renal function is being increasingly recognized, although not well understood. Dr. Aditya Bagrodia and colleagues evaluated 905 patients undergoing radical nephrectomy (N=610) or partial nephrectomy (N=295) at multiple institutions.
Mean age of the overall cohort was 57.5 years and mean duration of follow-up was 78 months. Development of de novo hyperlipidemia (HL) was assessed, defined as hyperlipoproteinemia, hypercholesterolemia, or hypertriglyceridemia at least 6 months after surgery, with laboratory values meeting National Cholesterol Education Program ATP III definitions. PN and RN groups were compared, and risk factors for developing HL were assessed. Groups did not differ significantly in pre-operative rates of CKD ≥ III and HL, however post-operative CKD ≥ III was significantly greater in the RN vs PN cohort (45.7% vs. 18.0%, p < 0.001) and de novo HL was more prevalent in the RN vs PN subset (23% vs 6.4%, p < 0.001). Interval to HL diagnosis was longer in PN vs RN (54 vs 44 months, p=0.03). Similarly, 5-year freedom from de novo HL probability was 96% vs 76% for PN vs. RN, respectively. Multivariable analysis demonstrated RN (OR 2.93, p=0.0107), pre-operative GFR < 60 mL/min/1.73m2 (OR 1.98, p=0.037), and post-operative GFR < 60 mL/min/1.73m2 (OR 7.89, p < 0.001) to be significantly associated with development of de novo HL.
These findings bring further attention to the importance of pre-existing quality and quantity of renal parenchyma, its potential impact on lipid metabolism, and additional benefits of renal preservation.
Presented by Aditya Bagrodia, Ryan Kopp, Reza Mehrazin, Michael Liss, Hossein Mirheydar, Ramzi Jabaji, Christopher Kane, Robert Wake, Anthony Patterson, Jim Wan, and Ithaar Derweesh at the American Urological Association (AUA) Annual Meeting - May 4 - 8, 2013 - San Diego Convention Center - San Diego, California USA
Reported for UroToday.com by Serge Ginzburg, MD