Associations between radiographic characteristics and change in renal function following partial nephrectomy using 24-hour creatinine clearance

Authors

  • Rodney H. Breau Department of Urology, Mayo Clinic, Rochester, MN
  • Aaron T.D. Clark Department of Surgery, Division of Urology, Ottawa University Hospital, Ottawa, ON
  • Chris Morash Department of Surgery, Division of Urology, Ottawa University Hospital, Ottawa, ON
  • Dean Fergusson Clinical Epidemiology Program, Ottawa Health ResearchInstitute, Ottawa, ON
  • Ilias Cagiannos Department of Surgery, Division of Urology, Ottawa University Hospital, Ottawa, ON

DOI:

https://doi.org/10.5489/cuaj.559

Abstract

Background: Radiographic characteristics may be associated with
the degree of renal function preservation following partial nephrectomy.
The purpose of this study was to determine the impact of
preoperative radiographic variables on change in renal function
using 24-hour urine creatinine clearance (uCrCl).

Methods: Patients with partial nephrectomy performed from
November 2003 to 2008 were enrolled in the study. Serum creatinine
and 24-hour urine was collected preoperatively and at
3, 6 and 12 months postoperatively. Computed tomography or
magnetic resonance imaging was used to determine tumour size,
tumour location and renal volume.

Results: Of the 36 patients, median age was 62 (range 30-78) and
21 (58%) were male. The mean tumour diameter was 2.8±1.4 cm.
Twenty-two (61%) tumours were located at the renal pole and
11 (31%) were endophytic. Overall, mean preoperative uCrCl
was 88.8±34.2 mL/min and mean postoperative uCrCl was
82.8±33.6 mL/min (6.8%; p < 0.01). On multivariable analysis,
no single characteristic was associated with a clinically prohibitive
decrease in renal function (-9.4% if endophitic, p = 0.06; -0.57%
per cm diameter, p = 0.73; and -6.9% if located at the renal pole,
p = 0.15). The total renal volume was also not significantly associated
with renal function change (-1.1% per 100 cc, p = 0.86).

Interpretation: Preoperative radiographic characteristics seem to
be associated with small changes in renal function following partial
nephrectomy. These data support renal functional benefits of partial
nephrectomy regardless of tumour size and location.

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Author Biographies

Rodney H. Breau, Department of Urology, Mayo Clinic, Rochester, MN

Aaron T.D. Clark, Department of Surgery, Division of Urology, Ottawa University Hospital, Ottawa, ON

Chris Morash, Department of Surgery, Division of Urology, Ottawa University Hospital, Ottawa, ON

Dean Fergusson, Clinical Epidemiology Program, Ottawa Health ResearchInstitute, Ottawa, ON

Ilias Cagiannos, Department of Surgery, Division of Urology, Ottawa University Hospital, Ottawa, ON

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How to Cite

Breau, R. H., Clark, A. T., Morash, C., Fergusson, D., & Cagiannos, I. (2013). Associations between radiographic characteristics and change in renal function following partial nephrectomy using 24-hour creatinine clearance. Canadian Urological Association Journal, 5(1), 45–8. https://doi.org/10.5489/cuaj.559

Issue

Vol. 5 No. 1 (2011): February

Section

Original Research

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