Unexpected Outcomes of Renal Function after Radical Nephrectomy: Histology Relevance along with Clinical Aspects.

Autor: Di Marco F; Urological Research Institute (URI), Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy., Pani A; Nephrology, Dialysis and Transplantation, Università Degli Studi di Cagliari, G. Brotzu Hospital, 09134 Cagliari, Italy., Floris M; Nephrology, Dialysis and Transplantation, Università Degli Studi di Cagliari, G. Brotzu Hospital, 09134 Cagliari, Italy., Martini A; Unit of Urology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy., Dell'Antonio G; Unit of Pathology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy., Capitanio U; Urological Research Institute (URI), Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.; Unit of Urology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy., Bettiga A; Urological Research Institute (URI), Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy., Larcher A; Urological Research Institute (URI), Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.; Unit of Urology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy., Cinque A; Urological Research Institute (URI), Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy., Bertini R; Urological Research Institute (URI), Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.; Unit of Urology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy., Briganti A; Urological Research Institute (URI), Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.; Unit of Urology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy., Salonia A; Urological Research Institute (URI), Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.; Unit of Urology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy., Montorsi F; Urological Research Institute (URI), Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.; Unit of Urology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy., Trevisani F; Urological Research Institute (URI), Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.; Unit of Urology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2021 Jul 28; Vol. 10 (15). Date of Electronic Publication: 2021 Jul 28.
DOI: 10.3390/jcm10153322
Abstrakt: Acute kidney injury (AKI) and chronic kidney disease (CKD) are common events after radical nephrectomy (RN). In this study we aimed to predict AKI and CKD after RN relying on specific histological aspects. We collected data from a cohort of 144 patients who underwent radical nephrectomy. A histopathological review of the healthy part of the removed kidney was performed using an established chronicity score (CS). Logistic regression analyses were performed to predict AKI after RN, while linear regression analysis was adopted for estimated glomerular filtration rate (eGFR) variation at 1 year. The outcomes of the study were to determine variables correlated with AKI onset, and with eGFR decay at 1 year. The proportion of AKI was 64%. Logistic analyses showed that baseline eGFR independently predicted AKI (odds ratio 1.04, 95%CI 1.02:1.06). Moreover, AKI (Beta -16, 95%CI -21:-11), baseline eGFR (Beta -0.42, 95%CI -0.52:-0.33), and the presence of arterial narrowing (Beta 10, 95%CI 4:15) were independently associated with eGFR decline. Our findings showed that AKI onset and eGFR decline were more likely to occur with higher baseline eGFR and lower CS, highlighting that RN in normal renal function patients represents a more traumatic event than its CKD counterpart.
Databáze: MEDLINE
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