The Quantitative Link between Baseline Chronic Kidney Disease and Functional Decline after Minimal Invasive Partial...

Area of Science:

• Nephrology
• Urology
• Surgical Oncology

Background:

• Baseline renal function is critical for outcomes after partial nephrectomy (PN).
• The precise impact of pre-existing kidney function on postoperative decline remains unclear.

Purpose of the Study:

• To investigate the association between baseline renal function and kidney function decline after PN.
• To analyze the nonlinear relationship between preoperative eGFR and postoperative outcomes.

Main Methods:

• Retrospective analysis of 546 patients undergoing PN (2014-2021).
• Patients categorized into CKD (eGFR <60) and normal (eGFR ≥60) groups.
• Restricted cubic splines and Cox regression analyzed renal function changes.

Main Results:

• Average eGFR decline was -8.0% (percent) and -8.2 mL/min/1.73 m2 (absolute).
• Patients with compromised baseline function had more complications (34.5% vs. 16.1%) and CKD-upstaging (23.1% vs. 12.2%).
• A U-shaped pattern emerged for >25% eGFR decline risk across baseline function levels.

Conclusions:

• Compromised baseline renal function increases perioperative complication and functional decline risks.
• The relationship between baseline renal function and postoperative decline is nonlinear.