Pd43-03 functional Recovery After Partial Nephrectomy in a Solitary Kidney

Abstract

significant intergroup differences were observed in the postoperative preservation ratio of eGFR at 6 or 12 months of follow-up (full clamping 94.0% vs. selective clamping 92.7%, p[0.509; and full clamping 92.0% vs. selective clamping 91.6%, p[0.476, respectively).CONCLUSIONS: Selective clamping resulted in higher EBL rates than did full clamping in RAPN. However, selective clamping provided no renal functional advantage over full clamping in our propensity score-matched cohort.

Preoperative Age and Its Impact on Long-Term Renal Functional Decline after Robotic-Assisted Partial Nephrectomy: Insights from a Tertiary Referral Center

“…−0.76, p < 0.001). Cumulatively, our findings, along with the others present in the literature, unequivocally establish age as a key risk factor for renal function decline after surgery, while, in the setting of preexisting CKD, the impact of age is marginal over the effect of parenchymal preservation [13]. Nonetheless, these findings advocate age as the main actor for renal functional recovery, thus suggesting a potential relationship between age and number of nephrons.…”

“…Conversely, Hamilton et al [ 39 ] conducted a retrospective study of 1213 T1/T2 renal masses (677 PN vs. 536 RN) with CKD stage 2 and noted that age was not associated with eGFR < 45 (OR 1.0, p = 0.66), while RN vs. PN (OR 3.68, p < 0.001) and preexisting CKD [eGFR 60–45 (OR 3.30, p = 0.010)] were the only predictor in their multivariable logistic regression model. In this nuanced scenario of preexisting CKD, the findings of Hamilton et al [ 39 ] highlight parenchyma preservation [ 13 ], over other clinical parameters such as age, as a strong predictor of CKD-S3b. Dissimilar to the previous studies, we used a prospective database of 258 RAPN, thus reducing the potential source of bias.…”

“…However, radical nephrectomy (RN) remains a cornerstone of surgical intervention, offering solid and comparable cancer outcomes to PN, with a lower risk profile for complications [ 9 ]. Conversely, while PN might result in a lesser decline in the estimated glomerular filtration rate (eGFR), a considerable number of patients may still experience a decline [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ], and the development of an eGFR below 45 mL/min/1.73 m 2 (CKD stage ≥ 3b) has been associated with poorer survival outcomes [ 21 ]. RCC is known to be influenced by metabolic factors [ 22 , 23 , 24 ]; therefore, exploring risk factors associated with renal functional recovery after PN is of paramount importance.…”