Konstantinidis C, Trilla E, Lorente D, Morote J
Universidad Autónoma de Barcelona, Barcelona, España.
Universidad Autónoma de Barcelona, Barcelona, España; Servicio de Urología y Trasplante Renal, Hospital Universitario Vall d'Hebron, Barcelona, España.
Actas Urol Esp. 2016 Dec;40(10):601-607. doi: 10.1016/j.acuro.2016.04.007. Epub 2016 May 18.
The growing incidence of renal masses and the wide range of available treatments require predictive tools that support the decision making process. The RENAL index -Radius; Exophytic/endophytic; Nearness to sinus; Anterior/posterior; Location relative to polar lines- helps standardise the anatomy of a renal mass by differentiating 3 groups of complexity. Since the introduction of the index, there have been a growing number of studies, some of which have been conflicting, that have evaluated the clinical utility of its implementation.
To analyse the scientific evidence on the relationship between the RENAL index and the main strategies for managing renal masses.
A search was conducted in the Medline database, which found 576 references on the RENAL index. In keeping with the PRISM Declaration, we selected 100 abstracts and ultimately reviewed 96 articles.
The RENAL index has a high degree of interobserver correlation and has been validated as a predictive nomogram of histological results. In active surveillance, the index has been related to the tumour growth rate and probability of nephrectomy. In ablative therapy, the index has been associated with therapeutic efficacy, complications and tumour recurrence. In partial nephrectomy, the index has been related to the rate of complications, conversion to radical surgery, ischaemia time, function preservation and tumour recurrence, a finding also observed in radical nephrectomy.
The RENAL index is an objective, reproducible and useful system as a predictive tool of highly relevant clinical parameters such as the rate of complications, ischaemia time, renal function and oncological results in the various currently accepted treatments for the management of renal masses.
肾肿块的发病率不断上升，且有多种可用治疗方法，这就需要有预测工具来辅助决策过程。RENAL指数（半径；外生性/内生性；与窦的距离；前后位；相对于极线的位置）通过区分三组复杂性来帮助标准化肾肿块的解剖结构。自该指数推出以来，评估其临床应用价值的研究越来越多，其中一些研究结果相互矛盾。
分析关于RENAL指数与肾肿块主要管理策略之间关系的科学证据。
在Medline数据库中进行检索，共找到576篇关于RENAL指数的参考文献。按照PRISM声明，我们筛选出100篇摘要，最终审阅了96篇文章。
RENAL指数具有高度的观察者间相关性，已被验证为组织学结果的预测列线图。在主动监测中，该指数与肿瘤生长速度和肾切除概率相关。在消融治疗中，该指数与治疗效果、并发症和肿瘤复发相关。在部分肾切除术中，该指数与并发症发生率、转为根治性手术、缺血时间、肾功能保留和肿瘤复发相关，在根治性肾切除术中也观察到了这一现象。
RENAL指数是一个客观、可重复且有用的系统，可作为预测工具，用于预测当前各种公认的肾肿块治疗方法中与并发症发生率、缺血时间、肾功能和肿瘤学结果等高度相关的临床参数。
