[Relation between severity of atherosclerosis and progression of renal disease in nephrectomized patients]
| Autor: | Enrique Dorado, María V. Mouesca, Marina Khoury, Diego Barreiro, Norberto Lafós, Silvia Rausch |
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| Rok vydání: | 2017 |
| Předmět: |
lcsh:Immunologic diseases. Allergy
Male Time Factors lcsh:R lcsh:Medicine Middle Aged urologic and male genital diseases Atherosclerosis Kidney Nephrectomy Severity of Illness Index lcsh:Infectious and parasitic diseases Risk Factors Disease Progression Humans lcsh:RC109-216 Female Renal Insufficiency Chronic lcsh:RC581-607 chronic kidney disease Aged Glomerular Filtration Rate Retrospective Studies |
| Zdroj: | Medicina (Buenos Aires), Vol 77, Iss 2, Pp 95-99 (2017) |
| ISSN: | 0025-7680 |
| Popis: | Radical nephrectomy is associated with a progressive decline in renal function. Clinical parameters in post-nephrectomy insufficiency were described but the impact of histopathologic vascular findings in the non-neoplastic kidney of nephrectomy specimen, has been poorly studied. Our aim was to evaluate whether the severity of atherosclerosis in non-neoplastic renal tissue predicts the evolution of glomerular filtration rate in patients undergoing total nephrectomy. Thirty-one non-donor patients with unilateral radical nephrectomy were included. Average age was 68.5 ± 11.8 years, 80% had a history of hypertension, 64% overweight and 51% were smokers. The glomerular filtration rate was estimated preoperatively, postoperatively and at 6, 12 and 24 months after surgery. Arteriolosclerosis was scored based on degree of narrowing of the vascular lumen (stage 0: no vascular narrowing; stage 1: less than 25%; stage 2: 25-50%; stage 3: more than 50%). Ten patients in stage 0 had higher basal glomerular filtration rate (75 ± 13 ml/min/1.73 m2) than eight patients in stage 2 or 3 (55 ± 22 ml/min/1.73 m2) (p 0.0886). At the last postoperative evaluation, the glomerular filtration rate was 60 ± 13 ml/min/1.73 m2 (stage 0) and 39 ± 11 ml/min/1.73 m2 (stage 2 or 3) (p = 0.05). The decrease in glomerular filtration rate was higher in patients with more severe degrees of atherosclerosis but the difference was not statistically significant. The histological evaluation of the severity of arteriosclerosis in the whole kidney allows the identification of patients with a greater risk of decreased glomerular filtration rate after a post radical nephrectomy. |
| Databáze: | OpenAIRE |
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