Preoperative GFR predicts kidney function after PN

  • Tanaka H & al.
  • J Urol
  • 3 Oct 2018

  • curated by Craig Hicks
  • Clinical Essentials
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Takeaway

  • Preoperative glomerular filtration rate (GFR) is the best predictor of kidney function after partial nephrectomy (PN), simply by presuming 89% of function will be saved.

Why this matters

  • This correlation was stronger than for 4 methods based on preoperative imaging and could improve patient counseling.

Study design

  • Researchers analyzed the health records of patients undergoing PN (N=428).
  • They measured both pre- and postoperative ipsilateral parenchymal mass, using contrast-enhanced CT imaging and estimated ipsilateral-percent parenchymal mass preserved (PPMP) via 4 methods:
    • subjective estimation,
    • quantitative estimation,
    • contact surface area, and
    • tumor radius, exophytic/endophytic properties, nearness to collecting system or sinus, anterior/posterior descriptor, and location relative to polar lines.
  • Funding: None.

Key results

  • Prediction of final global GFR was strong for all 4 methods (all r=0.91).
  • Prediction was equally strong for presuming that 89% of the preoperative global-GFR would be saved in each case (r=0.91).
  • Preoperative-GFR was the strongest predictor of final global-GFR; it was >10-fold more effective than estimated-PPMP or solitary-kidney status.

Limitations

  • The study was single-center, retrospective, and limited to patients with unifocal tumors.

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