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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Robot-Assisted Kidney Transplantation
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Does race impact functional outcomes in patients undergoing robotic partial nephrectomy?

Ugo G Falagario1,2, Alberto Martini1,3, John Pfail1

  • 1Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Translational Andrology and Urology
|May 19, 2020
PubMed
Summary

Robotic partial nephrectomy (RPN) outcomes were similar for African American and Caucasian patients, despite higher hypertension rates in African Americans. Further research is needed to confirm these findings in larger patient groups.

Keywords:
Acute kidney injury (AKI)chronic kidney disease (CKD)functional outcomepartial nephrectomy

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Area of Science:

  • Urology
  • Nephrology
  • Surgical Oncology

Background:

  • The impact of race on functional outcomes following robotic partial nephrectomy (RPN) remains under investigation.
  • This study evaluated clinical and pathological characteristics of African American (AA) and Caucasian patients undergoing RPN.

Purpose of the Study:

  • To analyze the association between race and functional outcomes after RPN.
  • To compare clinical and pathological characteristics between AA and Caucasian patients undergoing RPN.

Main Methods:

  • Retrospective analysis of a multi-institutional database of 999 RPN patients.
  • Matched 63 AA patients (1:3) to Caucasian patients based on age, gender, CCI, and renal score.
  • Used logistic and Cox regression to assess predictors of acute kidney injury (AKI) and estimated glomerular filtration rate (eGFR) reduction.

Main Results:

  • AA patients had higher rates of hypertension (58.7% vs. 35.4%, P=0.001).
  • No significant difference in AKI or significant eGFR reduction between AA and Caucasian patients post-RPN.
  • AKI was the only significant predictor of eGFR reduction (HR 2.49, P=0.019).

Conclusions:

  • RPN functional outcomes were not significantly different between AA and Caucasian patients.
  • Higher prevalence of hypertension in AA patients did not translate to disparate renal function outcomes post-RPN.
  • Larger cohort studies are required to validate these findings.