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• W2000533237 abstract "You have accessJournal of UrologyKidney Cancer: Localized IV1 Apr 2014MP59-18 CHRONIC KIDNEY DISEASE DUE TO SURGERY (CKD-S): RELATIVE RATES OF PROGRESSION AND SURVIVAL Sevag Demirjian, Brian Lane, Ithaar Derweesh, Toshio Takagi, Amr Fergany, and Steven Campbell Sevag DemirjianSevag Demirjian More articles by this author , Brian LaneBrian Lane More articles by this author , Ithaar DerweeshIthaar Derweesh More articles by this author , Toshio TakagiToshio Takagi More articles by this author , Amr FerganyAmr Fergany More articles by this author , and Steven CampbellSteven Campbell More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1814AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Chronic kidney disease (CKD) is in general associated with a higher likelihood of progression to end stage renal disease and increased mortality rates. However, the manner in which nephron loss occurs may modify the rate of progression of CKD and overall survival. Methods Patients with suspected renal malignancy who had a new baseline GFR < 60 ml/min/1.73 m2 six weeks after surgery were divided into two groups: CKD-S (surgically induced kidney disease, preoperative GFR > 60), and CKD-M/S (preexisting CKD due to medical causes followed by surgery). An independent cohort of subjects with CKD-M (entirely due to medical causes; no surgery involved) was also analyzed. Results 2,150 of 4,329 subjects with suspected renal malignancy had new-baseline GFR < 60 ml/min/1.73 m2 six weeks following surgery, comprising CKD-S (n=1097), and CKD-M/S (n=1053), whereas the CKD-M group consisted of 42,658 subjects. The CKD-M and CKD-M/S groups were older in age compared to the CKD-S group, had higher incidence of medical comorbidities (diabetes, hypertension, and congestive heart failure), and lower preoperative GFR (all p < 0.001). The CKD-M/S group had lower new baseline GFR (37±10) compared to the CKD-S (48±9) and CKD-M (47±10) groups (p <0.001). The probability of progressive decline in renal function (50% drop in GFR or need for dialysis) at 3 years was lowest for CKD-S, intermediate for CKD-M/S and highest for CKD-M when age, gender, race, comorbidities, and new baseline GFR were taken into account (p<0.001). Non-renal cancer related mortality was substantially lower for CKD-S when compared to the other groups (p<0.001). Conclusions Our data suggest that CKD due to surgical removal of nephrons has a lower rate of kidney disease progression and less impact on survival when compared to medical causes of CKD. This data has potential implications with respect to patient counseling about partial vs. radical nephrectomy in select patients with a normal contralateral kidney. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e657 Peer Review Report Advertisement Copyright & Permissions© 2014MetricsAuthor Information Sevag Demirjian More articles by this author Brian Lane More articles by this author Ithaar Derweesh More articles by this author Toshio Takagi More articles by this author Amr Fergany More articles by this author Steven Campbell More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2000533237 title "MP59-18 CHRONIC KIDNEY DISEASE DUE TO SURGERY (CKD-S): RELATIVE RATES OF PROGRESSION AND SURVIVAL" @default.
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