Does Glomerular Filtration Rate at Discharge After Partial Nephrectomy Predict Long-Term Glomerular Filtration Rate...

Area of Science:

• Nephrology
• Urology
• Surgical Outcomes

Background:

• Predicting long-term glomerular filtration rate (GFR) after partial nephrectomy (Pnx) is crucial for patient confidence in maintained renal function.
• Assessing GFR stability post-Pnx is vital, especially in diverse urban populations.
• Understanding postoperative renal function trends informs patient management and expectations.

Purpose of the Study:

• To evaluate the stability of GFR in a diverse inner-city cohort following minimally invasive partial nephrectomy (Pnx).
• To compare preoperative (pre-op) and discharge (DC) GFR with long-term GFR (12-18 months post-op).
• To identify predictors of long-term GFR after Pnx.

Main Methods:

• Retrospective review of 162 patients undergoing minimally invasive Pnx.
• Comparison of pre-op, DC, and long-term (12-18 months) GFR measurements.
• Multivariate linear regression analysis to identify predictors of long-term GFR.

Main Results:

• Mean GFR decreased from pre-op (70.7) to long-term (66.5), a significant change (p=0.002).
• No significant difference was found between DC GFR (68.3) and long-term GFR (66.5) (p=0.248).
• Both pre-op GFR (β=0.532) and DC GFR (β=0.312) were significant predictors of long-term GFR (R²=0.608).

Conclusions:

• Long-term GFR is stable relative to GFR at hospital discharge following Pnx in this cohort.
• Patients achieve a GFR plateau after surgery, with minimal renal function change at 14 months.
• Preoperative and discharge GFR are valuable indicators for predicting long-term renal function post-partial nephrectomy.