Urology, The Third Central Clinical College of Tianjin Medical University, Tianjin, 300170, China.
Urology, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin, 300170, China.
Int Urol Nephrol. 2024 May;56(5):1617-1625. doi: 10.1007/s11255-023-03901-w. Epub 2023 Dec 23.
To explore the relationship between the residual glomerular filtration rate (GFR) on the operated side and the GFR on the contralateral side following partial nephrectomy (PN) in patients with localized renal cell carcinoma (RCC).
Following institutional review board approval, we conducted a retrospective analysis of clinical records from May 2018 to July 2023, involving 118 patients who underwent partial nephrectomy for unilateral localized kidney tumors (T1-T2). Glomerular filtration rate data were assessed using single photon emission computed tomography (SPECT)/computed tomography imaging [using 9mTc-DTPA (diethylenetriaminepentaacetic acid) renal dynamic imaging]. The independent determinants of postoperative renal function or renal function change were determined using linear regression analysis. In addition, the patient's demographic, clinical, and nephrometry characteristics were collected.
A total of 58 patients were finally enrolled. The preoperative and postoperative GFR of bilateral kidneys showed a significant positive correlation. Postoperative GFR of the operated kidney was the independent predictor of GFR of contralateral kidney (p = 0.001). Tumor diameter (p = 0.036), age (p = 0.005), and postoperative GFR of the contralateral kidney (p = 0.001) were all independent predictors of postoperative GFR of the operated kidney. ΔGFR1 was the independent predictor of ΔGFR2. Results showed that a more pronounced postoperative decline in GFR on the operated side corresponded to a weaker compensatory capacity of the contralateral-side kidney.
During the course of the surgical procedure, the active endeavor to safeguard the renal function of the operated kidney side holds paramount importance, which yields positive outcomes for postoperative kidney function on the contralateral side, consequently contributing to the overall preservation of renal function.
探讨局限性肾细胞癌（RCC）患者肾部分切除术后术侧残肾功能（GFR）与对侧 GFR 的关系。
本研究经机构审查委员会批准，回顾性分析了 2018 年 5 月至 2023 年 7 月接受单侧局限性肾肿瘤（T1-T2）肾部分切除术的 118 例患者的临床资料。采用单光子发射计算机断层扫描（SPECT）/计算机断层扫描成像（使用 99mTc-DTPA[二乙三胺五乙酸]肾动态成像）评估肾小球滤过率数据。采用线性回归分析确定术后肾功能或肾功能变化的独立决定因素。此外，还收集了患者的人口统计学、临床和肾脏测量学特征。
共纳入 58 例患者。双侧肾脏术前和术后 GFR 呈显著正相关。术侧肾脏术后 GFR 是对侧肾脏 GFR 的独立预测因子（p=0.001）。肿瘤直径（p=0.036）、年龄（p=0.005）和对侧肾脏术后 GFR（p=0.001）均为术侧肾脏术后 GFR 的独立预测因子。ΔGFR1 是 ΔGFR2 的独立预测因子。结果表明，术侧 GFR 术后下降越明显，对侧肾脏的代偿能力越弱。
在手术过程中，积极保护术侧肾脏功能至关重要，这对术后对侧肾脏功能有积极影响，有助于整体保护肾功能。
