Acta Medica Okayama 72巻 3号
2018-06 発行

Renal Function after Nephrectomy Influences the Risk of Cardiovascular Events

Kambara, Taiki Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Tanimoto, Ryuta Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Araki, Motoo Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Saika, Takashi Department of Urology, Hiroshima City Hospital
Hashimoto, Hideaki Department of Urology, Okayama Central Hospital
Oeda, Tadashi Department of Urology, Onomichi Municipal Hospital
Tsushima, Tomoyasu Department of Urology, Okayama Medical Center
Hayata, Shunji Department of Urology, Tottori Municipal Hospital
Nasu, Yasutomo Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Kobayashi, Yasuyuki Okayama Urological Research Group
Publication Date
2018-06
Abstract
We retrospectively analyzed the factors related to postoperative cardiovascular (CV) events in patients undergoing partial nephrectomy (PN) or radical nephrectomy (RN) for clinical T1 renal cell carcinoma (RCC). We identified 570 patients who underwent PN or RN for T1 renal cell carcinoma between January 1998 and December 2009 at our institution and related hospitals. We determined the cumulative incidence rate of CV events and overall survival (OS) using Kaplan-Meier survival curves with a log-rank test, and we evaluated the risk for an increase in CV events and OS using Cox proportional hazard regression. Of the 570 patients, 171 underwent PN and 399 underwent RN. The type of surgery was not significantly related with CV events. The only factor that significantly increased the risk of CV events in both the univariate (HR 2.67, p=0.006) and multivariate analyses (HR 2.14, p=0.044) was a postoperative estimated glomerular filtration rate (eGFR) <45 ml/min/1.73 m2. Postoperative eGFR was also a significant risk factor for OS in the univariate analysis (HR 2.38, p=0.0104), but not in the multivariate model. Postoperative renal function was a significant independent predictor of the incidence of subsequent CV events.
Document Type
Original Article
Keywords
renal cell carcinoma
nephrectomy
partial nephrectomy
renal function
Link to PubMed
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