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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
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Changes in kidney function according to ischemia type during partial nephrectomy for T1a kidney cancer
Junghoon Lee1, Young Cheol Hwang2, Sangjun Yoo1
1Department of Urology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, Korea.
Scientific Reports
|March 11, 2022
Summary
Zero/selective ischemia during partial nephrectomy may preserve postoperative renal function better than cold ischemia. This technique showed fewer estimated glomerular filtration rate (eGFR) decreases and less kidney tissue change.
Area of Science:
- Nephrology
- Urology
- Surgical Innovation
Background:
- Partial nephrectomy is a standard treatment for T1a renal masses.
- Ischemic techniques during partial nephrectomy can impact postoperative renal function.
- Cold ischemia and zero/selective ischemia are two common methods used.
Purpose of the Study:
- To compare postoperative estimated-glomerular-filtration-rate (eGFR) and parenchymal changes between cold ischemia and zero/selective ischemia in T1a renal mass patients.
- To identify factors associated with renal function changes after open partial nephrectomy.
Main Methods:
- Analysis of 104 patients undergoing open partial nephrectomy for T1a masses between 2008-2018.
- Comparison of renal function (eGFR change) and kidney tissue changes (parenchymal enhancement, thickness) between cold ischemia (n=53) and zero/selective ischemia (n=51) groups.
- Multivariable analysis to determine predictors of postoperative renal function.
Main Results:
- The cold ischemia group had significantly more patients with a 10% or 25% decrease in eGFR (p=0.032, p=0.006).
- Multivariable analysis identified preoperative eGFR, ischemic type, and percent change in parenchymal thickness as significant factors associated with 12-month postoperative renal function (p<0.05).
- A negative correlation was found between parenchymal thickness change and postoperative renal function change (r=-0.277, p=0.012).
Conclusions:
- Zero/selective ischemia may offer an advantage in preserving postoperative renal function compared to cold ischemia.
- Changes in eGFR are associated with decreased parenchymal thickness and the type of ischemia used.
- Parenchymal thickness changes on CT correlate with renal function outcomes after partial nephrectomy.
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