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Ciorcan M, Negru Ș, Bardan R, Cumpănaș A, Mattar I, Bitar Y, Chișavu L, Marc L, Schiller A, Mihăescu A. The Impact of Chronic Kidney Disease on the Mortality Rates of Patients with Urological Cancers-An Analysis of a Uro-Oncology Database from Eastern Europe. J Pers Med 2023; 13:1572. [PMID: 38003887 PMCID: PMC10672193 DOI: 10.3390/jpm13111572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
(1) Background: The relationship between chronic kidney disease (CKD) and urological cancers is complex, as most of these cancers are diagnosed in patients with advanced ages, when the kidney function may be already impaired. On the other hand, urological cancers could represent a risk factor for CKD, significantly reducing the life expectancy of the patients. The main objective of our study was to analyze the impact of CKD on the overall mortality of patients diagnosed with the most frequent types of urological cancers. (2) Material and Methods: We conducted an observational retrospective cohort study on a group of 5831 consecutive newly diagnosed cancer patients, followed over a 2-year period (2019-2020), from a large Oncology Hospital in Romania. From this group, we selected only the patients diagnosed with urological malignancies, focusing on prostate cancer, bladder cancer and renal cancer; finally, 249 patients were included in our analysis. (3) Results: In the group of patients with prostate cancer (n = 146), the 2-year overall mortality was 62.5% for patients with CKD, compared with 39.3% for those with no initial CKD (p < 0.05). In the group of patients with bladder cancer (n = 62), the 2-year overall mortality was 80% for patients with initial CKD, compared with 45.2% for the patients with no initial CKD (p < 0.05). Finally, in the group of patients with renal cell carcinoma (n = 41), the 2-year overall mortality was 60% for patients with initial CKD, compared with 50% for the patient group with no initial CKD (p < 0.05). Various correlations between specific oncologic and nephrological parameters were also analyzed. (4) Conclusions: The presence of CKD at the moment of the urological cancer diagnosis is associated with significantly higher 2-year mortality rates.
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Affiliation(s)
- Mircea Ciorcan
- Department of Clinical Practical Skills, Victor Babes University of Medicine and Pharmacy, 300041 Timișoara, Romania;
- Center of Advanced Research in Cardiovascular Pathology and Hemostaseology, Victor Babes University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Șerban Negru
- Department of Oncology, Victor Babes University of Medicine and Pharmacy, 300041 Timișoara, Romania;
- Oncohelp Oncology Center, 300239 Timișoara, Romania
| | - Răzvan Bardan
- Department of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timișoara, Romania;
- Department of Urology, Clinical Emergency County Hospital, 300723 Timișoara, Romania; (I.M.); (Y.B.)
| | - Alin Cumpănaș
- Department of Urology, Victor Babes University of Medicine and Pharmacy, 300041 Timișoara, Romania;
- Department of Urology, Clinical Emergency County Hospital, 300723 Timișoara, Romania; (I.M.); (Y.B.)
| | - Iasmina Mattar
- Department of Urology, Clinical Emergency County Hospital, 300723 Timișoara, Romania; (I.M.); (Y.B.)
| | - Yahya Bitar
- Department of Urology, Clinical Emergency County Hospital, 300723 Timișoara, Romania; (I.M.); (Y.B.)
| | - Lazăr Chișavu
- Department of Nephrology, Victor Babes University of Medicine and Pharmacy, 300041 Timișoara, Romania; (L.C.); (L.M.); (A.S.); (A.M.)
- Department of Nephrology, Clinical Emergency County Hospital, 300723 Timișoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Luciana Marc
- Department of Nephrology, Victor Babes University of Medicine and Pharmacy, 300041 Timișoara, Romania; (L.C.); (L.M.); (A.S.); (A.M.)
- Department of Nephrology, Clinical Emergency County Hospital, 300723 Timișoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Adalbert Schiller
- Department of Nephrology, Victor Babes University of Medicine and Pharmacy, 300041 Timișoara, Romania; (L.C.); (L.M.); (A.S.); (A.M.)
- Department of Nephrology, Clinical Emergency County Hospital, 300723 Timișoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Adelina Mihăescu
- Department of Nephrology, Victor Babes University of Medicine and Pharmacy, 300041 Timișoara, Romania; (L.C.); (L.M.); (A.S.); (A.M.)
- Department of Nephrology, Clinical Emergency County Hospital, 300723 Timișoara, Romania
- Center for Molecular Research in Nephrology and Vascular Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timișoara, Romania
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da Silva Soares E, Rocha CC, Valente FL, Dos Anjos LRA, de Oliveira FLD, de Oliveira Loures C, Rocha PT, Castro VR, Sarandy TB, Borges APB. Platelet count and MCHC as independent prognostic markers for feline mammary carcinomas. Res Vet Sci 2023; 164:105024. [PMID: 37827061 DOI: 10.1016/j.rvsc.2023.105024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 08/16/2023] [Accepted: 09/18/2023] [Indexed: 10/14/2023]
Abstract
Mammary neoplasms are common in felines species and represent a significant disease for its unfavorable prognosis. Changes in the blood count and serum biochemical profile of these patients have potential as non-invasive prognostic markers prior to mastectomy, however, they are poorly described in literature. In this study univariate and multivariate analyses were performed using these factors to determine the effect of each parameter on the one-year survival time after the surgical procedure in these animals. The median overall survival (OS) and the disease-free survival (DFS) were 365 and 242 days, respectively. In univariate analysis, values within the reference range of monocyte, platelet and creatinine counts were identified as significant prognostic factors for OS and only creatinine was significant for DFS (P < 0.05). In the multivariate analysis, platelets and mean corpuscular hemoglobin concentration (MCHC) remained independent prognostic factors for OS. The results presented suggest that monocytes, platelets and creatinine may be important non-invasive pre-surgical prognostic markers, and that platelet count and MCHC are independent prognostic markers for feline mammary carcinomas (FMC). The correlation between such alterations is of important relevance for veterinary oncology, and prospective studies are needed to validate their clinical use and that platelet count and MCHC are independent prognostic markers for FMC. The results found in this study can also be studied in human medicine, regarding blood markers in human breast cancer (HBC).
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Affiliation(s)
| | | | | | | | | | | | - Pâmela Thalita Rocha
- Department of Veterinary, Federal University of Viçosa (UFV), Viçosa, MG, Brazil
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Ning C, Hu X, Liu F, Lin J, Zhang J, Wang Z, Zhu Y. Post-surgical outcomes of patients with chronic kidney disease and end stage renal disease undergoing radical prostatectomy: 10-year results from the US National Inpatient Sample. BMC Nephrol 2019; 20:278. [PMID: 31337353 PMCID: PMC6651956 DOI: 10.1186/s12882-019-1455-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 07/04/2019] [Indexed: 12/19/2022] Open
Abstract
Background Chronic kidney disease (CKD) and end stage renal disease (ESRD) are not well characterized in prostate cancer patients. This study aimed to examine the clinical characteristics and postsurgical outcomes of patients with or without CKD and ESRD undergoing radical prostatectomy for prostate cancer. Methods This population-based, retrospective study used patient data from the Nationwide Inpatient Sample, the largest all-payer US inpatient care database. From 2005 to 2014, 136,790 male patients aged > 20 years diagnosed with prostate cancer and who received radical prostatectomy were included. Postoperative complications, postoperative acute kidney injury (AKI) and urinary complications, and length of hospital stay were compared between patients with or without underlying CKD and ESRD. Results After adjusting for relevant factors, the CKD group had a significantly higher risk of postoperative complications than the non-CKD group. In addition, the CKD group had a 5-times greater risk of postoperative AKI and urinary complications than the non-CKD group. Both CKD and ESRD groups had significantly longer hospital stays than the non-CKD group. Patients receiving RARP had a lower risk of postoperative complications than those who received open radical prostatectomy, regardless of having CKD or not. Both non-CKD and CKD patients receiving RARP had shorter hospital stays than those who received open surgery. Conclusions Prostate cancer patients with underlying CKD had significantly greater risk of postoperative complications, postoperative AKI and urinary complications, and longer hospital stays than those without CKD. The use of RARP significantly shortened hospital stays and reduced complications for these patients. Electronic supplementary material The online version of this article (10.1186/s12882-019-1455-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chen Ning
- Department of Urology, Capital Medical University Beijing Friendship Hospital, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China.,Beijing Key Laboratory of Tolerance Induction and Organ Protection in Transplantation, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China
| | - Xinyi Hu
- Department of Urology, Capital Medical University Beijing Friendship Hospital, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China.,Beijing Key Laboratory of Tolerance Induction and Organ Protection in Transplantation, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China
| | - Fangming Liu
- Department of Urology, Capital Medical University Beijing Friendship Hospital, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China.,Beijing Key Laboratory of Tolerance Induction and Organ Protection in Transplantation, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China
| | - Jun Lin
- Department of Urology, Capital Medical University Beijing Friendship Hospital, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China.,Beijing Key Laboratory of Tolerance Induction and Organ Protection in Transplantation, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China
| | - Jian Zhang
- Department of Urology, Capital Medical University Beijing Friendship Hospital, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China.,Beijing Key Laboratory of Tolerance Induction and Organ Protection in Transplantation, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China
| | - Zhipeng Wang
- Department of Urology, Capital Medical University Beijing Friendship Hospital, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China.,Beijing Key Laboratory of Tolerance Induction and Organ Protection in Transplantation, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China
| | - Yichen Zhu
- Department of Urology, Capital Medical University Beijing Friendship Hospital, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China. .,Beijing Key Laboratory of Tolerance Induction and Organ Protection in Transplantation, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China.
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Kuroda K, Asakuma J, Horiguchi A, Kawaguchi M, Shinchi M, Masunaga A, Tasaki S, Sato A, Ito K. Chronic kidney disease and positive surgical margins as prognosticators for upper urinary tract urothelial carcinoma patients undergoing radical nephroureterectomy. Mol Clin Oncol 2019; 10:547-554. [PMID: 30967949 DOI: 10.3892/mco.2019.1829] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 03/18/2019] [Indexed: 11/06/2022] Open
Abstract
Chronic kidney disease (CKD) is a common condition among elderly patients and has been reported to be a biomarker for the presence of malignant disease. In addition, unfavorable outcomes for patients with upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy can be due to independent clinical factors. Therefore, the present study analyzed the clinicopathological data of patients with UTUC, who underwent radical nephroureterectomy at our institution, to clarify whether preoperative CKD and other factors are independent predictors of the shorter disease-specific and/or recurrence-free survival time of these patients. A retrospective review of 187 patients who underwent radical nephroureterectomy was conducted, and patients were followed for at least 3 months postoperatively. The clinicopathological factors that are thought to have potentially significant roles in the progression and metastasis of malignant tumors and for disease-specific and recurrence-free survival were evaluated. Positive surgical margins and an estimation of the glomerular filtration rate (eGFR) of <60 were independent factors for the shorter disease-specific survival time in multivariate analysis with Cox's proportional hazards model [hazard ratio (HR), 2.401: 95% confidence interval (CI), 1.044-5.255; and HR, 2.371: 95% CI, 1.024-5.898, respectively]. Another multivariate analysis also revealed that positive surgical margins (HR, 4.477; 95% CI, 2.042-9.469), and preoperative eGFR <60 (HR, 2.362; 95% CI, 1.067-5.592) were independent factors for the worse recurrence-free survival rate in all patients. Patients with UTUC who had eGFR <60 as well as positive surgical margins had significantly shorter time to disease-specific mortality and extraurothelial recurrence. The present study demonstrated that patients with UTUC undergoing radical nephroureterectomy who have CKD as well as positive surgical margins should be carefully followed up postoperatively.
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Affiliation(s)
- Kenji Kuroda
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan
| | - Junichi Asakuma
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan
| | - Akio Horiguchi
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan
| | - Makoto Kawaguchi
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan
| | - Masayuki Shinchi
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan
| | - Ayako Masunaga
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan
| | - Shinsuke Tasaki
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan
| | - Akinori Sato
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan
| | - Keiichi Ito
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan
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Yu HS, Hwang JE, Chung HS, Cho YH, Kim MS, Hwang EC, Oh KJ, Kim SO, Jung SI, Kang TW, Kwon DD, Park K, Ryu SB, Jung SH, Hur YH, Noh JH, Kim MK, Seo IY, Kim CS, Kang SG, Kang SH, Cheon J. Is preoperative chronic kidney disease status associated with oncologic outcomes in upper urinary tract urothelial carcinoma? A multicenter propensity score-matched analysis. Oncotarget 2017; 8:66540-66549. [PMID: 29029534 PMCID: PMC5630434 DOI: 10.18632/oncotarget.16239] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 03/06/2017] [Indexed: 01/18/2023] Open
Abstract
Purpose The aim of this study was to determine the effect of preoperative chronic kidney disease (CKD) on the prognosis of patients with upper urinary tract urothelial carcinoma (UTUC) who had undergone radical nephroureterectomy (RNU). Results The median follow-up period was 31.1 months (interquartile range: 16.2-55.7 months). Among the study patients, 224 patients in the non-CKD group were selected via propensity score matching. The median recurrence-free, cancer-specific, and overall survival were significantly shorter for patients with preoperative CKD than for non-CKD patients (p = 0.001, p = 0.001, and p = 0.001, respectively). According to multivariable Cox regression analysis, preoperative CKD was related to worse recurrence-free (hazard ratio [HR]: 1.81, 95% confidence interval [CI]: 1.15-2.86, p = 0.011), cancer-specific (HR: 2.44, 95% CI: 1.44-4.14, p = 0.001), and overall survival (HR: 1.66, 95% CI: 1.15-2.40, p = 0.007). Methods A total of 566 patients who underwent RNU at 6 institutions from 2004 to 2014 were retrospectively reviewed. Of these patients, 342 had an estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m2 (non-CKD group) and 224 patients had an eGFR <60 ml/min/1.73 m2 (CKD group). To adjust for potential baseline confounders, 224 patients in the non-CKD group were selected by propensity matching. Clinicopathological variables and survival rates were compared between the 2 groups. Conclusions Preoperative CKD appears to be an important independent prognostic factor for oncologic outcomes in patients with UTUC.
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Affiliation(s)
- Ho Song Yu
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Jun Eul Hwang
- Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Korea
| | - Ho Seok Chung
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Yang Hyun Cho
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Myung Soo Kim
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Eu Chang Hwang
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Kyung Jin Oh
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Sun-Ouck Kim
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Seung Il Jung
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Taek Won Kang
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Dong Deuk Kwon
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Kwangsung Park
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Soo Bang Ryu
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea.,Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea
| | - Sung-Hoon Jung
- Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Hoe Hur
- Department of General Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Joon Hwa Noh
- Department of Urology, Kwangju Christian Hospital, Gwangju, Korea
| | - Myung Ki Kim
- Department of Urology, Chonbuk National University Medical School, Jeonju, Korea
| | - Ill Young Seo
- Department of Urology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
| | - Chul-Sung Kim
- Department of Urology, Chosun University School of Medicine, Gwangju, Korea
| | - Sung Gu Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Seok Ho Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jun Cheon
- Department of Urology, Korea University College of Medicine, Seoul, Korea
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Cywinski JB, Mascha EJ, Kurz A, Sessler DI. Estimated glomerular filtration rate better predicts 30-day mortality after non-cardiac surgery than serum creatinine: a retrospective analysis of 92,888 patients. Can J Anaesth 2015; 62:745-52. [PMID: 25920903 DOI: 10.1007/s12630-015-0398-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 04/13/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Serum creatinine is the most commonly used indicator of renal function, but its derivative, estimated glomerular filtration rate (eGFR), has been shown to be superior in non-surgical settings. It remains unknown if eGFR better predicts postoperative mortality in non-cardiac surgical patients. We thus tested the hypothesis that eGFR predicts 30-day mortality after non-cardiac surgery better than serum creatinine. METHODS We evaluated patients who had inpatient non-cardiac surgery of at least one hour duration during January 2006 to December 2011 at the Cleveland Clinic Main Campus and whose preoperative serum creatinine was measured within 30 days before surgery. The eGFR was calculated using the Chronic Kidney Disease-Epidemiology Collaboration equation. Preoperative eGFR was compared in a multivariable analysis with preoperative serum creatinine (both assessed as continuous variables) on the ability to predict 30-day mortality in all patients. Secondarily, the comparison was made within subgroups based on amount of blood loss, blood transfusion, and sex. RESULTS There were 92,888 patients included in the final analysis. The eGFR was a modestly better discriminator of 30-day mortality than serum creatinine, with an estimated c-statistic (95% confidence interval) of 0.67 (0.65 to 0.68) for eGFR vs 0.61 (0.59 to 0.63) for serum creatinine (P < 0.001). Furthermore, the eGFR was consistently a better discriminator of 30-day mortality across blood loss, transfusion, and sex groups. Reclassification analyses suggested improved individual predictions of 30-day mortality using eGFR compared with serum creatinine. Nevertheless, a multivariable combination of baseline characteristics of American Society of Anesthesiologists physical status, age, and body mass index (all P < 0.001) discriminated 30-day mortality with a c-statistic of 0.850. Adding eGFR to the model improved the c-statistic to only 0.851, while separately adding serum creatinine did not change the c-statistic. CONCLUSION The eGFR is a modestly better predictor of 30-day mortality than serum creatinine in patients having inpatient non-cardiac surgery. Given that eGFR is often reported by clinical laboratories and is otherwise easy to calculate, it should generally be used in preference to creatinine alone.
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Affiliation(s)
- Jacek B Cywinski
- Department of General Anesthesiology, Cleveland Clinic, 9500 Euclid Avenue/G31, Cleveland, OH, USA,
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Schmid M, Ravi P, Abd-El-Barr AERM, Klap J, Sammon JD, Chang SL, Menon M, Kibel AS, Fisch M, Trinh QD. Chronic kidney disease and perioperative outcomes in urological oncological surgery. Int J Urol 2014; 21:1245-52. [PMID: 25041641 DOI: 10.1111/iju.12563] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 06/15/2014] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To evaluate baseline renal dysfunction among patients undergoing urological oncological surgery and its impact on early postoperative outcomes. METHODS Between 2005 and 2011, patients who underwent minimally-invasive or open radical prostatectomy, partial nephrectomy and radical nephrectomy, or open radical cystectomy, respectively, were identified in the National Surgical Quality Improvement Program dataset. Preoperative kidney function was assessed using estimated glomerular filtration rate and staged according to National Kidney Foundation definitions. Multivariable logistic regression was used to model the association between preoperative renal function and the risk of 30-day mortality and major complications. Furthermore the impact of chronic kidney disease on operation time and length of hospital stay was assessed. RESULTS Overall, 13,168 patients underwent radical prostatectomy (65.4%), partial nephrectomy (10.7%) and radical nephrectomy (16.1%) and radical cystectomy (7.8%), respectively; 50.1% of evaluable patients had reduced kidney function (chronic kidney disease II), and a further 12.6, 0.7 and 0.9% were respectively classified into chronic kidney disease stages III, IV, and V. Chronic kidney disease was an independent predictor of 30-day major postoperative complications (chronic kidney disease III: odds ratio 1.61, P < 0.001; chronic kidney disease IV: odds ratio 2.24, P = 0.01), of transfusions (chronic kidney disease III: odds ratio 2.14, P < 0001), of prolonged length of stay (chronic kidney disease III: odds ratio 2.61, P < 0.001; chronic kidney disease IV: odds ratio 3.37, P < 0.001; and chronic kidney disease V: odds ratio 1.68; P = 0.03) and of 30-day mortality (chronic kidney disease III: odds ratio 4.15, P = 0.01; chronic kidney disease IV: odds ratio 10.10, P = 0.003; and chronic kidney disease V: odds ratio 17.07, P < 0.001) compared with patients with no kidney disease. CONCLUSIONS Renal dysfunction might be underrecognized in patients undergoing urological cancer surgery. Chronic kidney disease stages III, IV and V are independent predictors for poor 30-day postoperative outcomes.
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Affiliation(s)
- Marianne Schmid
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Division of Urologic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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