Intraoperative mannitol use does not improve long-term renal function outcomes after minimally invasive partial...

Area of Science:

• Nephrology
• Urology
• Surgical Oncology

Background:

• Minimally invasive partial nephrectomy (PN) is a standard treatment for kidney tumors.
• Preserving renal function after PN is crucial for patient outcomes.
• The role of perioperative interventions like mannitol in optimizing renal function after PN requires further clarification.

Purpose of the Study:

• To evaluate the impact of intravenous mannitol on renal function recovery following minimally invasive partial nephrectomy (PN).
• To compare estimated glomerular filtration rate (eGFR) outcomes in patients who received mannitol versus those who did not during PN.

Main Methods:

• Retrospective analysis of 285 minimally invasive PN cases.
• Comparison of renal function recovery using a multivariate generalized estimating equation linear model of eGFR.
• Adjustment for multiple confounding factors including nephrometry complexity, preoperative eGFR, and ischemia time.

Main Results:

• Mannitol use was not associated with significant differences in renal function recovery (eGFR) within 6 months post-PN.
• Patients receiving mannitol had similar eGFR trajectories compared to the control group, with an estimated effect of -0.7 mL/min/m(2) (95% CI -3.6-2.2, P = .6).
• No significant postoperative difference in eGFR was observed between the groups after adjusting for confounders.

Conclusions:

• Intravenous mannitol does not appear to influence renal function recovery after minimally invasive partial nephrectomy.
• Further prospective studies are warranted to definitively establish the role of mannitol in PN.
• Current evidence suggests mannitol may not be beneficial for preserving renal function in this surgical context.