Early trends and predictors of renal function following computed tomography-guided percutaneous cryoablation of a renal mass in patients with and without prior renal impairment.

Autor: Staziaki PV; Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.; Boston Medical Center, Boston University School of Medicine, Boston, MA, USA., Vadvala HV; Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.; Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, USA., Furtado VF; Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.; Boston Medical Center, Boston University School of Medicine, Boston, MA, USA., Daye D; Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Arellano RS; Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Uppot RN; Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Radiologia brasileira [Radiol Bras] 2020 May-Jun; Vol. 53 (3), pp. 141-147.
DOI: 10.1590/0100-3984.2019.0098
Abstrakt: Objective: To assess trends and predictors of the glomerular filtration rate (GFR) after renal mass cryoablation in patients with and without history of renal impairment.
Materials and Methods: This was a retrospective study of 39 patients who underwent computed tomography-guided percutaneous cryoablation of a renal mass, divided into two groups: those with prior renal impairment (PRI+); and those without prior renal impairment (PRI-). The GFR trend and the chronic kidney disease stage were evaluated at baseline, as well as at 1, 6, and 12 months after cryoablation. Predictors of GFR at 1 and 6 months were modeled with linear regression.
Results: In both groups, the mean GFR at 1 month and 6 months was significantly lower than at baseline ( p < 0.001 and p = 0.01, respectively). Although the GFR was lower across all time points in the PRI+ group (-26.1; p < 0.001), the overall trend was not statistically different from that observed in the PRI- group ( p = 0.89). Univariate analysis showed that the decline in GFR at 1 and 6 months correlated with the baseline GFR (0.77 and 0.63; p < 0.001 and p = 0.03, respectively) and with the size of the ablation zone (-7.6 and -12.84, respectively; p = 0.03 for both). However, in the multivariate model, baseline GFR was predictive only of GFR at 1 month ( p < 0.001).
Conclusion: The trend in GFR decline after cryoablation is similar for patients with and without a history of renal impairment. Baseline GFR predicts the mean GFR in the early post-cryoablation period.
Databáze: MEDLINE
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