| Journal: | International braz j urol |
| Database: | PERIÓDICA |
| System number: | 000434708 |
| ISSN: | 1677-5538 |
| Authors: | Kara, Önder1 Maurice, Matthew J1 Mouracade, Pascal1 Malkoc, Ercan1 Dagenais, Julien1 Çapraz, Mustafa2 Chavali, Jaya S1 Kara, Merve Yazici3 Kaouk, Jihad H1 |
| Institutions: | 1Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, Ohio. Estados Unidos de América 2Amasya University, Medical School, Amasya. Turquía 3Kocaeli Derince Training and Research Hospital, Kocaeli. Turquía |
| Year: | 2019 |
| Season: | Sep-Dic |
| Volumen: | 45 |
| Number: | 5 |
| Country: | Brasil |
| Language: | Inglés |
| Document type: | Artículo |
| Approach: | Analítico, descriptivo |
| English abstract | Purpose We investigated the association between preoperative proteinuria and early postoperative renal function after robotic partial nephrectomy (RPN). Patients and Methods We retrospectively reviewed 1121 consecutive RPN cases at a single academic center from 2006 to 2016. Patients without pre-existing CKD (eGFR≥60 mL/min/1.73m2) who had a urinalysis within 1-month prior to RPN were included. The cohort was categorized by the presence or absence of preoperative proteinuria (trace or greater (≥1+) urine dipstick), and groups were compared in terms of clinical and functional outcomes. The incidence of acute kidney injury (AKI) was assessed using RIFLE criteria. Univariate and multivariable models were used to identify factors associated with postoperative AKI. Results Of 947 patients, 97 (10.5%) had preoperative proteinuria. Characteristics associated with preoperative proteinuria included non-white race (p<0.01), preoperative diabetes (p<0.01) and hypertension (HTN) (p<0.01), higher ASA (p<0.01), higher BMI (p<0.01), and higher Charlson score (p<0.01). The incidence of AKI was higher in patients with preoperative proteinuria (10.3% vs. 4.6%, p=0.01). The median eGFR preservation measured within one month after surgery was lower (83.6% vs. 91%, p=0.04) in those with proteinuria; however, there were no significant differences by 3 months after surgery or last follow-up visit. Independent predictors of AKI were high BMI (p<0.01), longer ischemia time (p<0.01), and preoperative proteinuria (p=0.04). Conclusion Preoperative proteinuria by urine dipstick is an independent predictor of postoperative AKI after RPN. This test may be used to identify patients, especially those without overt CKD, who are at increased risk for developing AKI after RPN |
| Disciplines: | Medicina |
| Keyword: | Nefrología, Oncología, Cirugía, Neoplasias, Riñones, Lesión renal aguda, Proteinuria |
| Keyword: | Nephrology, Oncology, Surgery, Kidneys, Neoplasms, Proteinuria, Acute kidney injury |
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