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  • Title: Measuring the Impact of Medical Chronic Kidney Disease and Diabetes Mellitus on Renal Functional Decline Following Surgical Management of Renal Masses.
    Author: Mamut AE, Violette PD, Rowe NE, Cui F, Luke PP.
    Journal: Urology; 2016 May; 91():124-8. PubMed ID: 26919963.
    Abstract:
    OBJECTIVE: To identify risk factors for renal functional decline following extirpative renal surgery, and establish the relative impact of these factors on glomerular filtration rate (GFR). METHODS: We reviewed 224 consecutive patients with a normal contralateral kidney who underwent radical nephrectomy for a renal mass at a tertiary care center between 2002 and 2010. Multivariate linear regression was used to identify independent predictors of renal function. RESULTS: Mean patient age at time of surgery was 62.6 years and 58% of patients were male. On multivariate analysis, preoperative GFR and diabetes mellitus (DM) were independent predictors of 1-year postoperative renal function. Every 1.0 mL/min/1.73 m(2) of preoperative GFR corresponded to a loss of 0.50 mL/min/1.73 m(2) following extirpative renal surgery. Diabetic patients had a further decrease in GFR of 4.5 mL/min/1.73 m(2) (95% confidence interval 1.5-7.6) compared to patients without DM. CONCLUSION: Preoperative GFR and DM were independent predictors of postoperative renal function. This may represent a proportion of patients with medical renal disease that is not identified on the basis of preoperative GFR alone.
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