BACKGROUND: We investigated factors affecting mild (MRFD) and severe renal functional deterioration (SRFD) after radical nephrectomy with a special focus on the histopathology of nephrectomized non-neoplastic renal parenchyma. METHODS: MRFD was defined as a postoperative decline of percent estimated glomerular filtration rate (eGFR) lower than the value of the mean minus standard deviation (SD). SRFD was defined as a rate greater than the value of the mean plus SD. The histopathological factors of global glomerulosclerosis (GS) and arteriosclerosis in non-neoplastic renal parenchyma and multiple clinical factors were analyzed to determine whether they affected postoperative renal functional deterioration in 100 renal cell carcinoma cases. The prognoses, including non-cancer mortality, were collected from long-term follow-up data. RESULTS: A higher preoperative eGFR and a higher global GS extent in non-neoplastic renal parenchyma were independently associated with MRFD and SRFD, respectively. The cardiovascular disease-specific survival rates of the SRFD group and the group with global GS extent >14 % were significantly worse than those of their counterparts. CONCLUSIONS: This is the first report to identify global GS extent in nephrectomized non-neoplastic renal parenchyma as a factor affecting the development of life-threatening post-nephrectomy renal functional deterioration. Moreover, we are the first to advocate the importance of the characterization of favorable post-nephrectomy renal functional deterioration. The identification of MRFD and SRFD by histopathological evaluation of nephrectomized non-neoplastic renal parenchyma will contribute to personalized postoperative follow-up. It may improve follow-up of individual patients with SRFD by permitting collaboration with other clinical departments such as cardiology.
BACKGROUND: We investigated factors affecting mild (MRFD) and severe renal functional deterioration (SRFD) after radical nephrectomy with a special focus on the histopathology of nephrectomized non-neoplastic renal parenchyma. METHODS: MRFD was defined as a postoperative decline of percent estimated glomerular filtration rate (eGFR) lower than the value of the mean minus standard deviation (SD). SRFD was defined as a rate greater than the value of the mean plus SD. The histopathological factors of global glomerulosclerosis (GS) and arteriosclerosis in non-neoplastic renal parenchyma and multiple clinical factors were analyzed to determine whether they affected postoperative renal functional deterioration in 100 renal cell carcinoma cases. The prognoses, including non-cancer mortality, were collected from long-term follow-up data. RESULTS: A higher preoperative eGFR and a higher global GS extent in non-neoplastic renal parenchyma were independently associated with MRFD and SRFD, respectively. The cardiovascular disease-specific survival rates of the SRFD group and the group with global GS extent >14 % were significantly worse than those of their counterparts. CONCLUSIONS: This is the first report to identify global GS extent in nephrectomized non-neoplastic renal parenchyma as a factor affecting the development of life-threatening post-nephrectomy renal functional deterioration. Moreover, we are the first to advocate the importance of the characterization of favorable post-nephrectomy renal functional deterioration. The identification of MRFD and SRFD by histopathological evaluation of nephrectomized non-neoplastic renal parenchyma will contribute to personalized postoperative follow-up. It may improve follow-up of individual patients with SRFD by permitting collaboration with other clinical departments such as cardiology.
Authors: Christopher J Weight; Benjamin T Larson; Tianming Gao; Steven C Campbell; Brian R Lane; Jihad H Kaouk; Inderbir S Gill; Eric A Klein; Amr F Fergany Journal: Urology Date: 2010-05-10 Impact factor: 2.649
Authors: Gagan Gautam; David Lifshitz; Sergey Shikanov; Jocelyn M Moore; Scott E Eggener; Arieh L Shalhav; Anthony Chang Journal: J Urol Date: 2010-09-17 Impact factor: 7.450
Authors: Sevag Demirjian; Brian R Lane; Ithaar H Derweesh; Toshio Takagi; Amr Fergany; Steven C Campbell Journal: J Urol Date: 2014-04-18 Impact factor: 7.450
Authors: Sascha Pahernik; Stefanie Ziegler; Frederik Roos; Sebastian W Melchior; Joachim W Thüroff Journal: J Urol Date: 2007-06-11 Impact factor: 7.450
Authors: Susie L Hu; Anthony Chang; Mark A Perazella; Mark D Okusa; Edgar A Jaimes; Robert H Weiss Journal: J Am Soc Nephrol Date: 2016-03-09 Impact factor: 10.121