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Prognostic nomogram for renal insufficiency after radical or partial nephrectomy.
Maximiliano Sorbellini1, Michael W Kattan, Mark E Snyder
1Department of Urology, Memorial Sloan-Kettering Cancer Center, New York 10021, USA.
The Journal of Urology
|July 4, 2006
Summary
A new nomogram predicts the 7-year risk of renal insufficiency after kidney surgery. This tool aids in assessing outcomes for patients undergoing partial or radical nephrectomy.
Area of Science:
- Nephrology
- Urology
- Oncology
Background:
- Renal insufficiency is a potential complication following nephrectomy.
- Predicting postoperative renal function is crucial for patient management.
Purpose of the Study:
- To identify prognostic factors for renal insufficiency after partial or radical nephrectomy.
- To develop and validate a postoperative nomogram for predicting renal insufficiency.
Main Methods:
- Analysis of a prospectively updated renal tumor database (>1,500 patients).
- Included partial (161) and radical (857) nephrectomies for renal cortical tumors.
- Defined renal insufficiency by elevated serum creatinine (>2.0 mg/dl) postoperatively.
- Prognostic variables included preoperative creatinine, ASA score, kidney volume change, age, and sex.
Main Results:
- 12.3% of radical nephrectomy patients and 3.7% of partial nephrectomy patients developed renal insufficiency.
- The 7-year probability of freedom from renal insufficiency was 79.1%.
- A Cox proportional hazards regression model yielded a nomogram with a concordance index of 0.835.
Conclusions:
- A validated nomogram can predict the 7-year probability of renal insufficiency.
- This tool assists in risk stratification for patients undergoing nephrectomy.