Functional Parenchymal Volume-based Spectrum Score Is Able to Quantify Ischemic Injury After Partial Nephrectomy

Area of Science:

• Nephrology
• Urology
• Surgical Outcomes

Background:

• The Spectrum Score (SS) assesses acute ischemic injury post-partial nephrectomy but relies on renal scans.
• Renal scans may not be routinely available, limiting SS application in clinical practice.

Purpose of the Study:

• To externally validate a modified Spectrum Score (SS) calculation using functional parenchymal volumes (FPVs).
• To determine if FPV-based SS can quantify acute ipsilateral kidney injury and predict functional recovery after partial nephrectomy without renal scans.

Main Methods:

• Retrospective review of 174 patients undergoing partial nephrectomy (2015-2017).
• Functional parenchymal volumes (FPVs) calculated for relative renal function assessment.
• FPV-based SS developed using creatinine calculations and assessed for association with functional recovery.

Main Results:

• Preoperative ipsilateral kidney function, GFR, and warm ischemia time were associated with FPV-based SS.
• FPV-based SS was independently associated with functional recovery post-partial nephrectomy.

Conclusions:

• The FPV-based SS effectively quantifies acute ipsilateral renal dysfunction after partial nephrectomy.
• This novel metric, not requiring renal scans, predicts functional recovery, offering a practical alternative for clinical use.