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Host-related Risk Factors for Adherent Perinephric Fat in Healthy Individuals Undergoing Laparoscopic Living-donor
Shintaro Narita1, Teruaki Kumazawa, Norihiko Tsuchiya
1*Department of Urology, Akita University School of Medicine ∥Department of Pathology, Akita University School of Medicine ¶Center for Kidney Disease and Transplantation, Akita University Hospital ‡Department of Urology, Omagari Kousei Medical Center, Akita §Department of Urology, Yamagata University School of Medicine, Yamagata †AMED-CREST, Japan Agency for Medical Research and Development (AMED), Tokyo, Japan.
Purpose:
The purpose of this study is to assess the risk factors and characteristics of adherent perinephric fat (APF) in healthy individuals.
Patients And Methods:
Men who underwent laparoscopic donor nephrectomy were included. Video review was used to divide patients on the basis of APF severity. Relationship between APF scores and clinical and radiographic features was evaluated.
Results:
Of the 92 patients, 43 (46.7%) and 8 (8.7%) were categorized as APF and severe APF, respectively. The median total operative time was significantly associated with APF severity. Sex, body mass index, and perinephric fat area, stranding, and thickness were significantly associated with severe APF. In the multivariate analysis, perinephric fat areas and stranding were independent risk factors for severe APF (HR, 1.189 and 14.450, respectively). In the 44 analyzed cytokines, levels of sIL-6R in the perinephric adipose tissue-conditioned medium were significantly higher for APF group than that for non-APF group (P=0.049).
Conclusions:
Host-related risk factors for APF could predict surgical difficulty in patients undergoing partial nephrectomy.
Insights
Adherent perinephric fat (APF) is linked to operative time and patient characteristics. Perinephric fat area and stranding are key predictors of severe APF, potentially indicating surgical difficulty.
Area of Science:
- Nephrology
- Urology
- Surgical Oncology
Background:
- Adherent perinephric fat (APF) is a condition affecting the fat surrounding the kidney.
- Understanding APF risk factors is crucial for surgical planning.
Purpose of the Study:
- To identify risk factors and characteristics associated with adherent perinephric fat (APF) in healthy individuals.
- To evaluate the relationship between APF severity and clinical/radiographic features.
Main Methods:
- Analysis of 92 men undergoing laparoscopic donor nephrectomy.
- Video review to categorize APF severity.
- Multivariate analysis of clinical, radiographic, and cytokine data.
Main Results:
- 46.7% of patients had APF, and 8.7% had severe APF.
- APF severity correlated with operative time, sex, BMI, and fat characteristics.
- Perinephric fat area and stranding were independent risk factors for severe APF.
Conclusions:
- Host-related risk factors for APF can predict surgical difficulty.
- Elevated sIL-6R levels were observed in the APF group.
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