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- W2323514897 abstract "INTRODUCTION AND OBJECTIVES: Acute increase of serum creatinine (SCr) after partial nephrectomy (PN) is primarily due to parenchymal mass reduction or ischemia, however only ischemia can impact subsequent functional recovery. In the current study, we evaluate etiologies of acute kidney injury (AKI) after PN and their prognostic significance. METHODS: From 2007-2014, 83 solitary kidneys managed with PN had necessary studies for detailed analysis of function and parenchymal mass before/after surgery. AKI was classified by RIFLE (Risk/Injury/Failure/Loss/Endstage) defined by either standard criteria (comparison to preoperative SCr) or proposed criteria (comparison to projected postoperative SCr based on parenchymal mass reduction). Subsequent recovery was defined as percent function preserved normalized by percent mass saved. Predictive factors for AKI were evaluated by logistic regression. Relationship between AKI grade and subsequent functional recovery was assessed by linear regression. RESULTS: Median duration of warm ischemia (n1⁄439) was 20 minutes and hypothermia (n1⁄444) 29 minutes. Median parenchymal mass reduction was 11%. AKI occurred in 45 patients based on standard criteria and 38 based on proposed criteria, and reflected injury/failure (grade1⁄42/3) in 23 and 16 patients, respectively. On multivariable analysis, only ischemia time associated with AKI occurrence (p1⁄40.016). Based on the proposed criteria, median recovery from ischemia was 99% in patients without AKI and 95%, 90%, and 88% for patients with grades 1/2/3 AKI, respectively. AKI grade based on proposed criteria associated with subsequent recovery (p1⁄40.018), while AKI grade based on standard criteria failed to associate (p1⁄40.5). CONCLUSIONS: Parenchymal mass reduction and ischemia both contribute to acute changes in SCr after PN, however only classification of AKI by proposed criteria, which more accurately reflect the impact of ischemia, associates with subsequent functional recovery. While AKI associated with suboptimal recovery, even patients with grade 2/3 AKI reached 88-90% of recovery expected." @default.
- W2323514897 created "2016-06-24" @default.
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- W2323514897 date "2016-04-01" @default.
- W2323514897 modified "2023-09-25" @default.
- W2323514897 title "PD29-11 SURVIVAL OUTCOMES FOR LOCALIZED RENAL CELL CARCINOMA ACCORDING TO TUMOR LOCATION AND OPERATION METHOD (RADICAL VERSUS PARTIAL NEPHRECTOMY): A PROPENSITY MATCHED ANALYSIS" @default.
- W2323514897 doi "https://doi.org/10.1016/j.juro.2016.02.529" @default.
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