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C-index is associated with functional outcomes after laparoscopic partial nephrectomy.

Mary K Samplaski¹, Adrian Hernandez, Inderbir S Gill

¹Department of Urological Oncology, Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

The Journal of Urology

|November 2, 2010

Summary

The C-index, a renal mass descriptor, predicts kidney function after partial nephrectomy. A C-index below 2.5 increases the risk of significant estimated glomerular filtration rate decline.

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Area of Science:

Nephrology
Urology
Radiology

Background:

The C-index is a morphometric descriptor for renal masses, integrating tumor size and location.
Assessing kidney function post-nephrectomy is crucial for patient outcomes.

Purpose of the Study:

To investigate the association between the C-index and kidney function following laparoscopic partial nephrectomy.
To determine if the C-index can predict postoperative renal function decline.

Main Methods:

Retrospective review of 131 patients undergoing laparoscopic partial nephrectomy.
Calculation of the C-index from preoperative CT scans.
Estimation of glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease 2 equation.

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Main Results:

A C-index of 2.5 or less was associated with a 2.2-fold increased risk of a ≥30% decrease in eGFR.
The C-index showed a positive correlation with nadir eGFR and a negative correlation with eGFR percent decrease.
Multivariate analysis identified C-index and warm ischemia time as significant predictors of eGFR decrease.

Conclusions:

The C-index is a significant predictor of postoperative nadir eGFR and eGFR percent decrease after laparoscopic partial nephrectomy.
A C-index < 2.5 identifies patients at higher risk for substantial kidney function impairment post-surgery.