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• W2796427186 abstract "You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy II1 Apr 2018PD12-09 SURGICALLY-INDUCED HYPERTENSION AND CARDIOVASCULAR MORBIDITY FOLLOWING TREATMENT FOR LOCALIZED KIDNEY CANCER: THE IMPACT OF NEPHRONS LOSS Umberto Capitanio, Alessandro Larcher, Francesco Trevisani, Francesco Cianflone, Andrea Mari, Riccardo Campi, Riccardo Tellini, Alessandro Veccia, Alexandre Mottrie, Hendrik Van Poppel, Marco Carini, Claudio Simeone, Andrea Salonia, Andrea Minervini, Alessandro Antonelli, Francesco Montorsi, and Roberto Bertini Umberto CapitanioUmberto Capitanio More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , Francesco TrevisaniFrancesco Trevisani More articles by this author , Francesco CianfloneFrancesco Cianflone More articles by this author , Andrea MariAndrea Mari More articles by this author , Riccardo CampiRiccardo Campi More articles by this author , Riccardo TelliniRiccardo Tellini More articles by this author , Alessandro VecciaAlessandro Veccia More articles by this author , Alexandre MottrieAlexandre Mottrie More articles by this author , Hendrik Van PoppelHendrik Van Poppel More articles by this author , Marco CariniMarco Carini More articles by this author , Claudio SimeoneClaudio Simeone More articles by this author , Andrea SaloniaAndrea Salonia More articles by this author , Andrea MinerviniAndrea Minervini More articles by this author , Alessandro AntonelliAlessandro Antonelli More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Roberto BertiniRoberto Bertini More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.645AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Nephrons loss due to surgery for kidney cancer increases the risk of chronic kidney disease and has several sequelae that may compromise patient general health status. Previous investigations observed lower cardiovascular events after nephron-sparing surgery [NSS] relative to radical nephrectomy [RN]. The aim of the study is to investigate the effect of NSS on each specific cardiovascular category taking into account the temporal pattern of presentation. METHODS 2,056 patients diagnosed with a cT1-2 renal mass treated with NSS or RN at three tertiary care Institutions and collected into a prospective database were assessed. Study outcomes were: 1) surgically-induced hypertension [HT], defined either as de-novo diagnosis of HT requiring medication or worsening of previous HT requiring therapy modification 2) major cardiovascular events [MCE], defined as coronary heart disease, cerebrovascular event, thromboembolic event, dysrhythmias and peripheral arteriopathy. Smoothed Poisson cumulative curves were used to assess the rates of HT and MCE. Multivariable competing regression analysis [MVA] tested the effect of NSS vs RN on the outcomes after adjustment for age, gender, renal function, comorbidities, previous cardiovascular status, diabetes, smoking history, tumour size and year of surgery. Mann-Whitney U test was used to compare time to HT vs time to CVE. RESULTS The proportion of patients treated with NSS and RN were 61 and 39%, respectively. After a median follow-up of 51 mo. (IQR 19-100), the 5-year HT and MCE rates resulted 2.5 and 10% after NSS and 3.1 and 7.4% after RN, respectively. At MVA, RN was associated with higher HT risk (HR 2.06; 95%CI 1.12-3.79; p=0.02) but similar MCE risk (HR 0.82; CI 0.57-1.2, p=0.3) relative to NSS. Conversely, previous history of HT (HR 0.22; CI 0.11-0.44; p<0.0001) and previous history of MCE (HR 0.21; CI 0.08-0.56; p=0.002) were associated with a lower HT risk. Age (HR 1.05; CI 1.03-1.07; p<0.0001) and smoking history (HR 1.53; CI 1.05-2.22; p=0.03) were associated with higher MCE risk. Time from surgery to HT was shorter than time to MCT (median 18 vs 37 mo.; p=0.01). CONCLUSIONS Surgically-induced HT is an early event after surgery while MCE occur later. Relative to RN, NSS showed an independent protective effect on HT but not on MCE. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e242 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Umberto Capitanio More articles by this author Alessandro Larcher More articles by this author Francesco Trevisani More articles by this author Francesco Cianflone More articles by this author Andrea Mari More articles by this author Riccardo Campi More articles by this author Riccardo Tellini More articles by this author Alessandro Veccia More articles by this author Alexandre Mottrie More articles by this author Hendrik Van Poppel More articles by this author Marco Carini More articles by this author Claudio Simeone More articles by this author Andrea Salonia More articles by this author Andrea Minervini More articles by this author Alessandro Antonelli More articles by this author Francesco Montorsi More articles by this author Roberto Bertini More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2796427186 title "PD12-09 SURGICALLY-INDUCED HYPERTENSION AND CARDIOVASCULAR MORBIDITY FOLLOWING TREATMENT FOR LOCALIZED KIDNEY CANCER: THE IMPACT OF NEPHRONS LOSS" @default.
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