Preoperative versus Postoperative Compensation of the Contralateral Normal Kidney in Patients Treated with Radical Nephrectomy for Renal Cell Carcinoma

Background: We sought to identify the factors affecting renal compensatory processes that occur preoperatively as well as postoperatively in patients treated with radical nephrectomy (RNx) for renal cell carcinoma (RCC). Methods: We retrospectively reviewed the records of 906 patients treated with R...

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Autores principales:	Chung-Un Lee, Hyunsoo Ryoo, Jae-Hoon Chung, Wan Song, Minyong Kang, Hyun-Hwan Sung, Byong-Chang Jeong, Seong-Il Seo, Seong-Soo Jeon, Hyun-Moo Lee, Hwang-Gyun Jeon
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	renal compensation radical nephrectomy renal cell carcinoma Medicine R
Acceso en línea:	https://doaj.org/article/7a7a97e7db6145a283b8d9b2966bbb96
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spelling	oai:doaj.org-article:7a7a97e7db6145a283b8d9b2966bbb962021-11-11T17:33:33ZPreoperative versus Postoperative Compensation of the Contralateral Normal Kidney in Patients Treated with Radical Nephrectomy for Renal Cell Carcinoma10.3390/jcm102149182077-0383https://doaj.org/article/7a7a97e7db6145a283b8d9b2966bbb962021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4918https://doaj.org/toc/2077-0383Background: We sought to identify the factors affecting renal compensatory processes that occur preoperatively as well as postoperatively in patients treated with radical nephrectomy (RNx) for renal cell carcinoma (RCC). Methods: We retrospectively reviewed the records of 906 patients treated with RNx for RCC. We defined the early compensatory process (process 1) as compensatory adaptation of the contralateral normal kidney (CNK) before RNx. We defined the late compensatory process (process 2) as compensatory adaptation of the CNK after RNx. Total compensation was defined as the combination of these two processes. Multivariable logistic regression analyses were used to identify significant factors associated with processes 1, 2 and total compensation. Results: Mean preoperative, 1-week, and 5-year postoperative estimated glomerular filtration rates (eGFR) were 84.5, 57.6 and 63.7 mL/min/1.73 m<sup>2</sup>, respectively. Female sex (<i>p</i> < 0.001), lower body mass index (BMI) (<i>p</i> < 0.001), absence of hypertension (<i>p</i> = 0.019), lower preoperative eGFR (<i>p</i> < 0.001), larger tumor volume (<i>p</i> < 0.001), and larger CNK volume (<i>p</i> < 0.001) were significantly associated with process 1. Younger age (<i>p</i> = 0.019), higher BMI (<i>p</i> < 0.001), and absence of diabetes mellitus (DM) (<i>p</i> = 0.033) were significantly associated with process 2. Female sex (<i>p</i> < 0.001), younger age (<i>p</i> < 0.001), absence of DM (<i>p</i> = 0.002), lower preoperative eGFR (<i>p</i> < 0.001), and larger tumor (<i>p</i> = 0.001) and CNK volumes (<i>p</i> < 0.001) were significantly associated with total compensation. Conclusions: Different factors affected each compensatory process. Process 1 made a greater contribution to the entire renal compensatory process than process 2.Chung-Un LeeHyunsoo RyooJae-Hoon ChungWan SongMinyong KangHyun-Hwan SungByong-Chang JeongSeong-Il SeoSeong-Soo JeonHyun-Moo LeeHwang-Gyun JeonMDPI AGarticlerenal compensationradical nephrectomyrenal cell carcinomaMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4918, p 4918 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	renal compensation radical nephrectomy renal cell carcinoma Medicine R
spellingShingle	renal compensation radical nephrectomy renal cell carcinoma Medicine R Chung-Un Lee Hyunsoo Ryoo Jae-Hoon Chung Wan Song Minyong Kang Hyun-Hwan Sung Byong-Chang Jeong Seong-Il Seo Seong-Soo Jeon Hyun-Moo Lee Hwang-Gyun Jeon Preoperative versus Postoperative Compensation of the Contralateral Normal Kidney in Patients Treated with Radical Nephrectomy for Renal Cell Carcinoma
description	Background: We sought to identify the factors affecting renal compensatory processes that occur preoperatively as well as postoperatively in patients treated with radical nephrectomy (RNx) for renal cell carcinoma (RCC). Methods: We retrospectively reviewed the records of 906 patients treated with RNx for RCC. We defined the early compensatory process (process 1) as compensatory adaptation of the contralateral normal kidney (CNK) before RNx. We defined the late compensatory process (process 2) as compensatory adaptation of the CNK after RNx. Total compensation was defined as the combination of these two processes. Multivariable logistic regression analyses were used to identify significant factors associated with processes 1, 2 and total compensation. Results: Mean preoperative, 1-week, and 5-year postoperative estimated glomerular filtration rates (eGFR) were 84.5, 57.6 and 63.7 mL/min/1.73 m<sup>2</sup>, respectively. Female sex (<i>p</i> < 0.001), lower body mass index (BMI) (<i>p</i> < 0.001), absence of hypertension (<i>p</i> = 0.019), lower preoperative eGFR (<i>p</i> < 0.001), larger tumor volume (<i>p</i> < 0.001), and larger CNK volume (<i>p</i> < 0.001) were significantly associated with process 1. Younger age (<i>p</i> = 0.019), higher BMI (<i>p</i> < 0.001), and absence of diabetes mellitus (DM) (<i>p</i> = 0.033) were significantly associated with process 2. Female sex (<i>p</i> < 0.001), younger age (<i>p</i> < 0.001), absence of DM (<i>p</i> = 0.002), lower preoperative eGFR (<i>p</i> < 0.001), and larger tumor (<i>p</i> = 0.001) and CNK volumes (<i>p</i> < 0.001) were significantly associated with total compensation. Conclusions: Different factors affected each compensatory process. Process 1 made a greater contribution to the entire renal compensatory process than process 2.
format	article
author	Chung-Un Lee Hyunsoo Ryoo Jae-Hoon Chung Wan Song Minyong Kang Hyun-Hwan Sung Byong-Chang Jeong Seong-Il Seo Seong-Soo Jeon Hyun-Moo Lee Hwang-Gyun Jeon
author_facet	Chung-Un Lee Hyunsoo Ryoo Jae-Hoon Chung Wan Song Minyong Kang Hyun-Hwan Sung Byong-Chang Jeong Seong-Il Seo Seong-Soo Jeon Hyun-Moo Lee Hwang-Gyun Jeon
author_sort	Chung-Un Lee
title	Preoperative versus Postoperative Compensation of the Contralateral Normal Kidney in Patients Treated with Radical Nephrectomy for Renal Cell Carcinoma
title_short	Preoperative versus Postoperative Compensation of the Contralateral Normal Kidney in Patients Treated with Radical Nephrectomy for Renal Cell Carcinoma
title_full	Preoperative versus Postoperative Compensation of the Contralateral Normal Kidney in Patients Treated with Radical Nephrectomy for Renal Cell Carcinoma
title_fullStr	Preoperative versus Postoperative Compensation of the Contralateral Normal Kidney in Patients Treated with Radical Nephrectomy for Renal Cell Carcinoma
title_full_unstemmed	Preoperative versus Postoperative Compensation of the Contralateral Normal Kidney in Patients Treated with Radical Nephrectomy for Renal Cell Carcinoma
title_sort	preoperative versus postoperative compensation of the contralateral normal kidney in patients treated with radical nephrectomy for renal cell carcinoma
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/7a7a97e7db6145a283b8d9b2966bbb96
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Preoperative versus Postoperative Compensation of the Contralateral Normal Kidney in Patients Treated with Radical Nephrectomy for Renal Cell Carcinoma

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