Renal function after radical nephrectomy: Development and validation of predictive models in Japanese patients

Abstract

Abbreviations & AcronymsObjectives: To develop and validate predictive models for postoperative estimated glomerular filtration rate and risk of chronic kidney disease after radical nephrectomy in Japanese patients. Methods: The present retrospective study included a development cohort of 209 patients without preoperative chronic kidney disease who underwent radical nephrectomy between 1994 and 2008, and were followed up for longer than 3 years, and a validation cohort of 144 similar such patients. Univariate and multivariate linear regression or logistic regression analyses were carried out to identify the independent predictors of estimated glomerular filtration rate or chronic kidney disease 3 years after radical nephrectomy. Incorporating all independent predictors, predictive models for postoperative renal function were developed and externally validated. Results: Age, the presence of diabetes mellitus, and preoperative estimated glomerular filtration rate were independent predictors of both postoperative estimated glomerular filtration rate and chronic kidney disease. A formula for predicting the postoperative estimated glomerular filtration rate and a nomogram for predicting the risk of postoperative chronic kidney disease were developed. The adjusted R 2 of the formula and area under the receiver operating characteristic curves of the nomogram were 0.446 and 0.865 in the development cohort, and 0.396 and 0.787 in the validation cohort, respectively. Conclusions: We developed and validated novel predictive models for the postoperative renal function 3 years after radical nephrectomy in Japanese patients.

Predictors of new‐onset chronic kidney disease in patients managed surgically for T1a renal cell carcinoma: An Australian population‐based analysis

“…The association between CKD development and poorer baseline kidney function is also well known . In the present study, preoperative eGFR was the only variable found to have a significant interaction with nephrectomy type, such that even those with relatively high eGFR measures preoperative (70‐79 mL/min per 1.73 m 2 ) who underwent RN were substantially more likely to develop new CKD than those with lower preoperative eGFR (60‐69 mL/min per 1.73 m 2 ) who underwent PN.…”

Prediction of significant estimated glomerular filtration rate decline after renal unit removal to aid in the clinical choice between radical and partial nephrectomy in patients with a renal mass and normal renal function

“…Our findings dovetail with a recent report by Isharwal et al [25] demonstrating that comorbidity status fails to predict renal functional decline after renal surgery. The literature in this space is contradictory [23,26,27], but the greatest predictor of eGFR decline to ≤45 mL/min/1.73 m 2 remains RN [28,29]. Woldu et al [30] recently compared renal functional outcomes after NSS and RN among patients with CKD I and II.…”

Clinical predictors of the estimated glomerular filtration rate 1 year after radical nephrectomy in Japanese patients

“…Yokoyama et al [30] first reported the equation to predict eGFR 3 years after RN. They showed age, presence of diabetes mellitus, and preoperative eGFR were significant predictors of postnephrectomy eGFR.…”