Predictors of renal function after open and robot-assisted partial nephrectomy: A propensity score-matched study

Area of Science:

• Nephrology
• Urology
• Surgical Oncology

Background:

• Renal function preservation is crucial after partial nephrectomy.
• Comparing open partial nephrectomy (OPN) and robot-assisted partial nephrectomy (RAPN) outcomes is essential for patient care.

Purpose of the Study:

• To identify predictors of short- and long-term renal function after OPN and RAPN.
• To compare postoperative outcomes between OPN and RAPN.

Main Methods:

• Retrospective review of 896 patients undergoing OPN or RAPN.
• Propensity score matching (1:1 ratio) to compare outcomes.
• Multivariate logistic regression to identify predictors of acute kidney injury (AKI) and chronic kidney disease (CKD) progression.

Main Results:

• RAPN was associated with longer warm ischemic time but lower estimated blood loss, positive surgical margins, major complications, and CKD progression.
• Multivariate analysis indicated RAPN is more favorable for renal function preservation.
• Higher baseline estimated glomerular filtration rate (eGFR) predicted AKI risk but decreased CKD progression risk.

Conclusions:

• Baseline eGFR, warm ischemic time, and surgical approach (OPN vs. RAPN) are independent predictors of AKI and CKD progression.
• RAPN demonstrates advantages over OPN in reducing complications and preserving renal function.