Renal Insufficiency is an Independent Risk Factor for Complications After Partial Nephrectomy

A. A. Hakimi, S. Rajpathak, L. Chery, E. Shapiro, R. Ghavamian

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose: We identify and describe the postoperative outcomes of a single surgeon partial nephrectomy cohort. We performed univariate and multivariate analysis on preoperative patient characteristics, and their association with increased length of stay and postoperative complication rates. Materials and Methods: Perioperative characteristics of 146 consecutive patients undergoing partial nephrectomy were recorded. Postoperative complications were defined as those occurring within 30 days using the Clavien postoperative complication scale. We conducted logistic regression analysis to evaluate the development of complications and linear regression analysis to determine the effect on length of stay. Results: In a linear regression model patients with renal insufficiency had a mean of 1.7 ± 0.6 days longer length of stay compared to those with normal renal function (p = 0.006). Complications occurred in 48.5% in the renal insufficiency group compared with 16.8% in the other cohort (p = 0.0004). There were no mortalities. On univariable analysis 4 factors were significantly associated with the development of complications including race (p = 0.03), preoperative Modification of Diet in Renal Disease less than 60 (p <0.0001), tumor size greater than 4 cm (p = 0.03) and estimated blood loss (p = 0.04). On multivariable analysis the 2 factors of Modification of Diet in Renal Disease less than 60 (p = 0.003) and race (p = 0.03) remained significant. The odds ratio for complications comparing patients with renal insufficiency to the normal cohort, adjusting for confounding factors, was 4.58 (95% CI 1.65-12.65). Conclusions: Preoperative renal insufficiency defined as Modification of Diet in Renal Disease less than 60 and nonAfrican-American race, which may be related to Modification of Diet in Renal Disease, are predictive of complications after partial nephrectomy. Decreased Modification of Diet in Renal Disease is an independent risk factor for increased length of hospital stay and increased complication rate in partial nephrectomy.

Original languageEnglish (US)
Pages (from-to)43-47
Number of pages5
JournalJournal of Urology
Volume183
Issue number1
DOIs
StatePublished - Jan 2010

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Diet Therapy
Nephrectomy
Renal Insufficiency
Length of Stay
Kidney
Linear Models
Statistical Factor Analysis
Regression Analysis
Multivariate Analysis
Logistic Models
Odds Ratio
Mortality
Neoplasms

Keywords

  • carcinoma
  • complications
  • laparoscopy
  • multivariate analysis
  • nephrectomy
  • renal cell

ASJC Scopus subject areas

  • Urology

Cite this

Renal Insufficiency is an Independent Risk Factor for Complications After Partial Nephrectomy. / Hakimi, A. A.; Rajpathak, S.; Chery, L.; Shapiro, E.; Ghavamian, R.

In: Journal of Urology, Vol. 183, No. 1, 01.2010, p. 43-47.

Research output: Contribution to journalArticle

Hakimi, AA, Rajpathak, S, Chery, L, Shapiro, E & Ghavamian, R 2010, 'Renal Insufficiency is an Independent Risk Factor for Complications After Partial Nephrectomy', Journal of Urology, vol. 183, no. 1, pp. 43-47. https://doi.org/10.1016/j.juro.2009.08.146
Hakimi, A. A. ; Rajpathak, S. ; Chery, L. ; Shapiro, E. ; Ghavamian, R. / Renal Insufficiency is an Independent Risk Factor for Complications After Partial Nephrectomy. In: Journal of Urology. 2010 ; Vol. 183, No. 1. pp. 43-47.
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AB - Purpose: We identify and describe the postoperative outcomes of a single surgeon partial nephrectomy cohort. We performed univariate and multivariate analysis on preoperative patient characteristics, and their association with increased length of stay and postoperative complication rates. Materials and Methods: Perioperative characteristics of 146 consecutive patients undergoing partial nephrectomy were recorded. Postoperative complications were defined as those occurring within 30 days using the Clavien postoperative complication scale. We conducted logistic regression analysis to evaluate the development of complications and linear regression analysis to determine the effect on length of stay. Results: In a linear regression model patients with renal insufficiency had a mean of 1.7 ± 0.6 days longer length of stay compared to those with normal renal function (p = 0.006). Complications occurred in 48.5% in the renal insufficiency group compared with 16.8% in the other cohort (p = 0.0004). There were no mortalities. On univariable analysis 4 factors were significantly associated with the development of complications including race (p = 0.03), preoperative Modification of Diet in Renal Disease less than 60 (p <0.0001), tumor size greater than 4 cm (p = 0.03) and estimated blood loss (p = 0.04). On multivariable analysis the 2 factors of Modification of Diet in Renal Disease less than 60 (p = 0.003) and race (p = 0.03) remained significant. The odds ratio for complications comparing patients with renal insufficiency to the normal cohort, adjusting for confounding factors, was 4.58 (95% CI 1.65-12.65). Conclusions: Preoperative renal insufficiency defined as Modification of Diet in Renal Disease less than 60 and nonAfrican-American race, which may be related to Modification of Diet in Renal Disease, are predictive of complications after partial nephrectomy. Decreased Modification of Diet in Renal Disease is an independent risk factor for increased length of hospital stay and increased complication rate in partial nephrectomy.

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