PMID- 25265210
OWN - NLM
STAT- MEDLINE
DCOM- 20151117
LR  - 20181202
IS  - 1557-900X (Electronic)
IS  - 0892-7790 (Linking)
VI  - 29
IP  - 4
DP  - 2015 Apr
TI  - The impact of ischemia on long-term renal function after partial nephrectomy in 
      the two kidney model.
PG  - 474-8
LID - 10.1089/end.2014.0476 [doi]
AB  - PURPOSE: To determine whether on-clamp partial nephrectomy (ON-PN) has any 
      significant impact on long-term renal function in a two kidney model. PATIENTS 
      AND METHODS: From November 1999 to July 2013, 607 patients underwent PN at our 
      institution. After excluding patients with solitary kidneys, multiple renal 
      masses, and follow-up less than 90 days, 331 remained. Patient demographics were 
      assessed, as was renal function based on pre- and postoperative 
      mercaptoacetyltriglycine (MAG-3) renal scans and change in estimated glomerular 
      filtration rate (eGFR) using the preoperative and most recent recorded creatinine 
      levels. RESULTS: There were a total of 236 patients who underwent ON-PN and 95 
      who underwent off-clamp PN (OFF-PN) during the study period. The longest 
      follow-up was 12.6 years with mean follow-up of 3 years. Mean ischemia time of 
      patients undergoing ON-PN was 25 minutes (range 8-63 min). No differences were 
      noted between the ON-PN and OFF-PN cohorts with respect to estimated change in 
      eGFR (ON-PN: -6.07 mL/min/1.73 m(2) vs OFF-PN: -6.00 mL/min/1.73 m(2), P=0.69). 
      No differences were noted in the % change in the MAG-3 renal scans (ON-PN: -0.77% 
      vs OFF-PN: -1.1%, P=0.94). A post hoc sensitivity analysis of the same two 
      variables stratified by age revealed no differences in change in estimated GFR or 
      % change in differential function on renal scan. CONCLUSIONS: In the two kidney 
      model, ischemia does not appear to affect long-term renal function outcomes after 
      PN. These data provide evidence that ON-PN is perfectly acceptable in the 
      appropriately selected patient with two kidneys.
FAU - Salevitz, Daniel A
AU  - Salevitz DA
AD  - Department of Urology, Mayo Clinic Hospital , Phoenix, Arizona.
FAU - Patton, Michael W
AU  - Patton MW
FAU - Tyson, Mark D 2nd
AU  - Tyson MD 2nd
FAU - Nunez-Nateras, Rafael
AU  - Nunez-Nateras R
FAU - Ferrigni, Erin N
AU  - Ferrigni EN
FAU - Andrews, Paul E
AU  - Andrews PE
FAU - Humphreys, Mitchell R
AU  - Humphreys MR
FAU - Castle, Erik P
AU  - Castle EP
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20141105
PL  - United States
TA  - J Endourol
JT  - Journal of endourology
JID - 8807503
SB  - IM
MH  - Aged
MH  - Carcinoma, Renal Cell/*surgery
MH  - Constriction
MH  - Female
MH  - *Glomerular Filtration Rate
MH  - Humans
MH  - Kidney/*blood supply/physiopathology
MH  - Kidney Neoplasms/*surgery
MH  - Male
MH  - Middle Aged
MH  - Nephrectomy/*methods
MH  - Retrospective Studies
MH  - *Warm Ischemia
EDAT- 2014/09/30 06:00
MHDA- 2015/11/18 06:00
CRDT- 2014/09/30 06:00
PHST- 2014/09/30 06:00 [entrez]
PHST- 2014/09/30 06:00 [pubmed]
PHST- 2015/11/18 06:00 [medline]
AID - 10.1089/end.2014.0476 [doi]
PST - ppublish
SO  - J Endourol. 2015 Apr;29(4):474-8. doi: 10.1089/end.2014.0476. Epub 2014 Nov 5.