Adaptive functional change of the contralateral kidney after partial nephrectomy

Partial nephrectomy aims to maintain renal function by nephron sparing; however, functional changes in the contralateral kidney remain unknown. We evaluate the functional change in the contralateral kidney using a diethylene triamine penta-acetic acid (DTPA) renal scan and determine factors predicting contralateral kidney function after partial nephrectomy. A total of 699 patients underwent partial nephrectomy, with a DTPA scan before and after surgery to assess the separate function of each kidney. Patients were divided into three groups according to initial contralateral glomerular filtration rate (GFR; group 1: <30 ml·min–1·1.73 m–2, group 2: 30–45 ml·min–1·1.73 m–2, and group 3: ≥45 ml·min–1·1.73 m–2). Multiple-regression analysis was used to identify the factors associated with increased GFR of the contralateral kidney over a 4-yr postoperative period. Patients in group 1 had a higher mean age and hypertension history, worse American Society of Anesthesiologists score, and larger tumor size than in the other two groups. The ipsilateral GFR changes at 4 yr after partial nephrectomy were –18.9, –3.6, and 3.9% in groups 1, 2, and 3, respectively, whereas the contralateral GFR changes were 10.8, 25.7, and 38.8%. Age [β: –0.105, 95% confidence interval (CI): –0.213; –0.011, P < 0.05] and preoperative contralateral GFR (β: –0.256, 95% CI: &...

Source: AJP: Renal Physiology - August 1, 2017 Category: Urology & Nephrology Authors: Choi, S. Y., Yoo, S., You, D., Jeong, I. G., Song, C., Hong, B., Hong, J. H., Ahn, H., Kim, C.-S. Tags: RESEARCH ARTICLE Source Type: research