Impact of short warm ischemic time on longitudinal kidney function and survival rate after partial nephrectomy for renal cell carcinoma in patients with pre-existing chronic kidney disease stage III: A multi-institutional propensity score-matched study
- Authors
- Chung, J.-S.; Hong, S.K.; Lee, S.C.; Jeong, C.W.; Kwak, C.; Kim, H.H.; Hong, S.H.; Kim, Y.J.; Kang, S.H.; Chung, J.; Kwon, T.G.; Chang, Hwang E.; Byun, S.-S.
- Issue Date
- Feb-2021
- Publisher
- W.B. Saunders Ltd
- Keywords
- Carcinoma; Chronic kidney disease; Nephrectomy; Renal cell; Warm ischemia
- Citation
- European Journal of Surgical Oncology, v.47, no.2, pp 470 - 476
- Pages
- 7
- Indexed
- SCIE
SCOPUS
- Journal Title
- European Journal of Surgical Oncology
- Volume
- 47
- Number
- 2
- Start Page
- 470
- End Page
- 476
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/28342
- DOI
- 10.1016/j.ejso.2020.06.016
- ISSN
- 0748-7983
1532-2157
- Abstract
- Purpose: It remains unclear whether a short warm ischemic time (WIT) improves long-term renal function after partial nephrectomy (PN) for patients with pre-existing chronic kidney disease (CKD). We evaluated renal function after PN according to WIT duration in patients with stage III CKD. Materials and methods: We identified 277 patients with stage III CKD who underwent PN during 2004–2017. Propensity score matching was used to created two matched groups of patients: Group A (WIT of <25 min) and Group B (WIT of ≥25 min). The outcomes of interest were longitudinal kidney function change, new-onset stage IV CKD (eGFR <30 mL/min/1.73 m2) and overall survival. Results: The two matched groups contained 85 patients each. The median follow-up durations were 49 months in Group A and 42 months in Group B. The median pre-treatment eGFRs were 52.4 mL/min/1.73 m2 in Group A and 52.6 mL/min/1.73 m2 in Group B. There were no differences in kidney function between the two groups throughout the follow-up period (P > 0.05). The 5-year rates of new-onset stage IV CKD were not significantly different between Group A and Group B (8.2% vs. 7.1%), with no significant difference in the risk of developing stage IV CKD in Group A (vs. group B, hazard ratio: 0.527, 95% confidence interval: 0.183–1.521; P = 0.236). The 5-year overall survival rates were 90.3% for Group A and 96.2% for Group B (P = 0.549). Conclusions: A short WIT was not associated with better postoperative kidney function or survival after PN in patients with stage III CKD. © 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
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Collections - 2. Clinical Science > Department of Urology > 1. Journal Articles
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