Quality and Quantity in Kidney Cancer Surgery: The Role of Nonneoplastic Kidney and Kidney Volumetrics in Predicting Postoperative Renal Function.

Abstract:

Objectives:To model renal function 2 years following radical nephrectomy with quantitative analyses using clinical, histopathologic, and renal composite cortical volumes (CCV). Methods:This retrospective study involved an assessment of the nonneoplastic kidney tissue by three blinded nephropathologists using modified Banff 1997 criteria for renal allograft pathology. Volumetric image acquisition was obtained by three independent radiologists using preoperative imaging. A 2-year estimated glomerular filtration (eGFR) calculator was created. Results:Among the 126 patients, median age was 60 years; median CCV, 398.1 cm3; preoperative eGFR, 77 mL/min/1.73 m2; and 2-year postoperative eGFR, 54 mL/min/1.73 m2. Of the subjects, 64% had hypertension, 26% diabetes, and 37% were smokers. Increasing age, glomerulopathy/sclerosis, tubulointerstitial scarring, and arteriosclerosis were statistically significantly and adversely associated with eGFR. Conversely, increasing CCV was associated with a higher eGFR. Conclusions:Quantitative analysis of the nephrectomized kidney in conjunction with patient age can accurately predict renal function at 2 years.

journal_name

Am J Clin Pathol

authors

Pruthi DK,Oomah S,Lu V,Ting T,Knickle C,Liss MA,Gibson IW,Kirkpatrick IDC,McGregor TB

doi

10.1093/ajcp/aqy107

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

108-115

issue

1

eissn

0002-9173

issn

1943-7722

pii

5096121

journal_volume

151

pub_type

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