Impact of ischemia on renal function after laparoscopic partial nephrectomy: a multicenter study.

Area of Science:

• Nephrology
• Urology
• Surgical Oncology

Background:

• Laparoscopic partial nephrectomy (LPN) is a standard treatment for kidney tumors.
• Assessing the impact of renal ischemia during LPN on long-term kidney function is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the influence of renal ischemia time on long-term global renal function after LPN.
• To determine if ischemia duration affects estimated glomerular filtration rate (eGFR) in patients with two functioning kidneys.

Main Methods:

• A multicenter cohort study of 401 patients undergoing LPN.
• Renal function assessed by eGFR (Modification of Diet in Renal Disease equation) preoperatively and postoperatively.
• Linear regression used to model the relationship between ischemia time and percent change in eGFR.

Main Results:

• Median ischemia time was 29 minutes.
• Postoperative eGFR change was -16%, and long-term change was -11%.
• Ischemia time was not associated with long-term eGFR change; shorter operative times and female gender were linked to better postoperative eGFR.

Conclusions:

• Renal ischemia within the studied range did not significantly impact long-term global renal function after LPN.
• The estimated glomerular filtration rate suggests that renal ischemia time is not a major determinant of long-term kidney function in this patient group.