Zhou Zhaohui, Li Zhiyong, Ning Kang, Xiong Longbin, Liu Huiming, Huang Yixin, Luo Xin, Peng Yulu, Chen Lijie, Ma Binglei, Zou Xiangpeng, Wei Wensu, Luo Cheng, Han Hui, Guo Shengjie, Dong Pei, Zhou Fangjian, Yu Chunping, Zhang Zhiling
Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, China.
State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
iScience. 2023 Aug 12;26(9):107610. doi: 10.1016/j.isci.2023.107610. eCollection 2023 Sep 15.
GFR reaches a new baseline, primarily correlating with nephron-mass preservation, 1-12 months after partial nephrectomy (PN). However, does the ipsilateral GFR experience subsequent decline, and does acute ischemic injury has long-term effect on the operated kidney? 319 patients with two kidneys and unilateral clamped PN were analyzed. All had preoperative, new-baseline, and latest follow-up imaging/serum creatinine levels. Annual ipsilateral GFR decline rate (AIGDR) was defined as new-baseline GFR minus latest follow-up GFR normalized by new-baseline GFR, per year. Spectrum score was used to reflect the degree of acute ischemic injury in the operated kidney. 100 subjects searching for health screening served as controls. Predictive factors for AIGDR were assessed. The median AIGDR was 2.25%, significantly higher than controls (0.88%, p = 0.036). With some contralateral hypertrophy, the global annual GFR decline was similar to that of controls (0.81% vs. 0.88%, p = 0.7). Spectrum score correlated significantly with AIGDR (p = 0.037). These results support that acute ischemic injury has long-term effect on the operated kidney.
肾部分切除术（PN）后1至12个月，肾小球滤过率（GFR）达到新的基线水平，主要与肾单位数量的保留相关。然而，患侧GFR随后是否会下降，急性缺血性损伤对手术侧肾脏是否有长期影响？对319例双肾且接受单侧钳夹PN手术的患者进行了分析。所有患者均有术前、新基线和最新随访时的影像学检查/血清肌酐水平。每年患侧GFR下降率（AIGDR）定义为（新基线GFR减去最新随访GFR）除以新基线GFR再乘以每年。采用频谱评分来反映手术侧肾脏急性缺血性损伤的程度。100名进行健康筛查的受试者作为对照。评估了AIGDR的预测因素。AIGDR的中位数为2.25%，显著高于对照组（0.88%，p = 0.036）。在对侧肾脏有一定程度肥大的情况下，总体每年GFR下降情况与对照组相似（0.81%对0.88%，p = 0.7）。频谱评分与AIGDR显著相关（p = 0.037）。这些结果支持急性缺血性损伤对手术侧肾脏有长期影响。
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