Changes in renal function after nephroureterectomy for upper urinary tract carcinoma: analysis of a large multicenter cohort (Radical Nephroureterectomy Outcomes (RaNeO) Research Consortium)
- Creators
- Tafuri A.
- Marchioni M.
- Cerrato C.
- Mari A.
- Tellini R.
- Odorizzi K.
- Veccia A.
- Amparore D.
- Shakir A.
- Carbonara U.
- Panunzio A.
- Trovato F.
- Catellani M.
- Janello L. M. I.
- Bianchi L.
- Novara G.
- Dal Moro F.
- Schiavina R.
- De Lorenzis E.
- Parma P.
- Cimino S.
- De Cobelli O.
- Maiorino F.
- Bove P.
- Crocerossa F.
- Cantiello F.
- D'Andrea D.
- Di Cosmo F.
- Porpiglia F.
- Ditonno P.
- Montanari E.
- Soria F.
- Gontero P.
- Liguori G.
- Trombetta C.
- Mantica G.
- Borghesi M.
- Terrone C.
- Del Giudice F.
- Sciarra A.
- Galosi A.
- Moschini M.
- Shariat S. F.
- Di Nicola M.
- Minervini A.
- Ferro M.
- Cerruto M. A.
- Schips L.
- Pagliarulo V.
- Antonelli A.
- Others:
- Tafuri, A.
- Marchioni, M.
- Cerrato, C.
- Mari, A.
- Tellini, R.
- Odorizzi, K.
- Veccia, A.
- Amparore, D.
- Shakir, A.
- Carbonara, U.
- Panunzio, A.
- Trovato, F.
- Catellani, M.
- Janello, L. M. I.
- Bianchi, L.
- Novara, G.
- Dal Moro, F.
- Schiavina, R.
- De Lorenzis, E.
- Parma, P.
- Cimino, S.
- De Cobelli, O.
- Maiorino, F.
- Bove, P.
- Crocerossa, F.
- Cantiello, F.
- D'Andrea, D.
- Di Cosmo, F.
- Porpiglia, F.
- Ditonno, P.
- Montanari, E.
- Soria, F.
- Gontero, P.
- Liguori, G.
- Trombetta, C.
- Mantica, G.
- Borghesi, M.
- Terrone, C.
- Del Giudice, F.
- Sciarra, A.
- Galosi, A.
- Moschini, M.
- Shariat, S. F.
- Di Nicola, M.
- Minervini, A.
- Ferro, M.
- Cerruto, M. A.
- Schips, L.
- Pagliarulo, V.
- Antonelli, A.
Description
Purpose: To investigate prevalence and predictors of renal function variation in a multicenter cohort treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). Methods: Patients from 17 tertiary centers were included. Renal function variation was evaluated at postoperative day (POD)—1, 6 and 12 months. Timepoints differences were Δ1 = POD-1 eGFR − baseline eGFR; Δ2 = 6 months eGFR − POD-1 eGFR; Δ3 = 12 months eGFR − 6 months eGFR. We defined POD-1 acute kidney injury (AKI) as an increase in serum creatinine by ≥ 0.3 mg/dl or a 1.5 1.9-fold from baseline. Additionally, a cutoff of 60 ml/min in eGFR was considered to define renal function decline at 6 and 12 months. Logistic regression (LR) and linear mixed (LM) models were used to evaluate the association between clinical factors and eGFR decline and their interaction with follow-up. Results: A total of 576 were included, of these 409(71.0%) and 403(70.0%) had an eGFR < 60 ml/min at 6 and 12 months, respectively, and 239(41.5%) developed POD-1 AKI. In multivariable LR analysis, age (Odds Ratio, OR 1.05, p < 0.001), male gender (OR 0.44, p = 0.003), POD-1 AKI (OR 2.88, p < 0.001) and preoperative eGFR < 60 ml/min (OR 7.58, p < 0.001) were predictors of renal function decline at 6 months. Age (OR 1.06, p < 0.001), coronary artery disease (OR 2.68, p = 0.007), POD-1 AKI (OR 1.83, p = 0.02), and preoperative eGFR < 60 ml/min (OR 7.80, p < 0.001) were predictors of renal function decline at 12 months. In LM models, age (p = 0.019), hydronephrosis (p < 0.001), POD-1 AKI (p < 0.001) and pT-stage (p = 0.001) influenced renal function variation (ß 9.2 ± 0.7, p < 0.001) during follow-up. Conclusion: Age, preoperative eGFR and POD-1 AKI are independent predictors of 6 and 12 months renal function decline after RNU for UTUC.
Additional details
- URL
- https://hdl.handle.net/11567/1108542
- URN
- urn:oai:iris.unige.it:11567/1108542
- Origin repository
- UNIGE