Changes in renal function after nephroureterectomy for upper urinary tract carcinoma: analysis of a large multicenter cohort (Radical Nephroureterectomy Outcomes (RaNeO) Research Consortium).

Content Provider	Europe PMC
Author	Tafuri, Alessandro Marchioni, Michele Cerrato, Clara Mari, Andrea Tellini, Riccardo Odorizzi, Katia Veccia, Alessandro Amparore, Daniele Shakir, Aliasger Carbonara, Umberto Panunzio, Andrea Trovato, Federica Catellani, Michele Janello, Letizia M. I. Bianchi, Lorenzo Novara, Giacomo Dal Moro, Fabrizio Schiavina, Riccardo De Lorenzis, Elisa Parma, Paolo Cimino, Sebastiano De Cobelli, Ottavio Maiorino, Francesco Bove, Pierluigi Crocerossa, Fabio Cantiello, Francesco D’Andrea, David Di Cosmo, Federica Porpiglia, Francesco Ditonno, Pasquale Montanari, Emanuele Soria, Francesco Gontero, Paolo Liguori, Giovanni Trombetta, Carlo Mantica, Guglielmo Borghesi, Marco Terrone, Carlo Del Giudice, Francesco Sciarra, Alessandro Galosi, Andrea Moschini, Marco Shariat, Shahrokh F. Di Nicola, Marta Minervini, Andrea Ferro, Matteo Cerruto, Maria Angela Schips, Luigi Pagliarulo, Vincenzo Antonelli, Alessandro
Abstract	PurposeTo investigate prevalence and predictors of renal function variation in a multicenter cohort treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC).MethodsPatients 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.ResultsA 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.ConclusionAge, preoperative eGFR and POD-1 AKI are independent predictors of 6 and 12 months renal function decline after RNU for UTUC.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00345-022-04156-3.
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ISSN	07244983
Journal	World Journal of Urology [World J Urol]
Volume Number	40
DOI	10.1007/s00345-022-04156-3
PubMed Central reference number	PMC9617815
Issue Number	11
PubMed reference number	36203101
e-ISSN	14338726
Language	English
Publisher	Springer Berlin Heidelberg
Publisher Date	2022-10-06
Publisher Place	Berlin/Heidelberg
Access Restriction	Open
Rights License	Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2022
Subject Keyword	Upper tract urothelial carcinoma Radical Nephroureterectomy Acute Kidney Injury Chronic Kidney Disease
Content Type	Text
Resource Type	Article
Subject	Urology