TY - JOUR
T1 - MP63-02 HOW A DONOR NEPHRECTOMY POPULATION CAN HELP CLARIFY THE EFFECTS OF WARM RENAL ISCHEMIA DURING PARTIAL NEPHRECTOMY
AU - Li, Roger
AU - Ruckle, Herbert C.
AU - Alsyouf, Muhannad
AU - Lightfoot, Michelle
AU - Schober, Jared
AU - Tryon, David
AU - Myklak, Kristene
AU - Culpepper, David
AU - Faaborg, Daniel
AU - Stokes, Phillip
AU - Arenas, Javier L.
AU - Baldwin, D. Duane
N1 - DISCLOSURES: The American Urological Association (AUA) is committed to maintaining transparency in its relationships. The AUA requires that individuals make full disclosures for themselves, their family and/or business partner of relationships, business transactions, leadership positions, presentations or publications prior to participating in AUA activities. All relevant relationships for the last 12 months should be disclosed.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - INTRODUCTION AND OBJECTIVES: The most important modifiable risk factors for kidney function after partial nephrectomy (PN) are the quantity of parenchyma removed and the length of warm ischemia time (WIT) although the relative importance of these two factors has been debated. In this study, the effects of WIT on renal function were investigated by comparing PN patients to completely healthy patients undergoing donor nephrectomy (DN). METHODS: A retrospective review was performed of 119 PN and 250 DN patients at a single academic institution. Baseline characteristics, WIT, and follow-up serum creatinine (sCr) at discharge, 1- 7months and at last follow-up were compared. Estimated GFR (eGFR) was calculated using sCr and the Modification of Diet on Renal Disease (MDRD) formula. Data was analyzed using the Mann-Whitney U and Chi-square tests as appropriate. RESULTS: The DN patients were younger (37.5 vs. 60.8; p 30 minutes at all time points including discharge (-42.7% vs. -4.1%; p 30 min WIT. This dramatic benefit of partial nephrectomy compared with radical nephrectomy in all patients emphasizes the benefit to GFR derived from renal parenchymal preservation. Surgeons should utilize warm renal ischemia when indicated if it facilitates the preservation of renal parenchyma.
AB - INTRODUCTION AND OBJECTIVES: The most important modifiable risk factors for kidney function after partial nephrectomy (PN) are the quantity of parenchyma removed and the length of warm ischemia time (WIT) although the relative importance of these two factors has been debated. In this study, the effects of WIT on renal function were investigated by comparing PN patients to completely healthy patients undergoing donor nephrectomy (DN). METHODS: A retrospective review was performed of 119 PN and 250 DN patients at a single academic institution. Baseline characteristics, WIT, and follow-up serum creatinine (sCr) at discharge, 1- 7months and at last follow-up were compared. Estimated GFR (eGFR) was calculated using sCr and the Modification of Diet on Renal Disease (MDRD) formula. Data was analyzed using the Mann-Whitney U and Chi-square tests as appropriate. RESULTS: The DN patients were younger (37.5 vs. 60.8; p 30 minutes at all time points including discharge (-42.7% vs. -4.1%; p 30 min WIT. This dramatic benefit of partial nephrectomy compared with radical nephrectomy in all patients emphasizes the benefit to GFR derived from renal parenchymal preservation. Surgeons should utilize warm renal ischemia when indicated if it facilitates the preservation of renal parenchyma.
UR - https://www.auajournals.org/doi/full/10.1016/j.juro.2015.02.2334
UR - http://www.jurology.com/article/S0022-5347(15)02645-2/abstract
UR - https://www.mendeley.com/catalogue/47a58f4c-549d-32ea-bd39-576ead501b79/
U2 - 10.1016/J.JURO.2015.02.2334
DO - 10.1016/J.JURO.2015.02.2334
M3 - Meeting abstract
VL - 193
JO - The Journal of Urology
JF - The Journal of Urology
IS - 4S
ER -