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