Pre-surgical chronic kidney disease continues to drive outcomes in the modern era of minimally invasive renal surgery, despite advances in technology

Purpose To assess the impact of preoperative chronic kidney disease (CKD) on perioperative morbidity and mortality in a contemporary cohort undergoing renal surgery in an era of increased prevalence of minimally invasive surgery and partial nephrectomy. Methods The National Surgery Quality Improveme...

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Bibliographic Details
Published in:International urology and nephrology 2022, Vol.54 (1), p.1-7
Main Authors: Omil-Lima, Danly, Gupta, Karishma, Weinstein, Ilon, Kent, Mercedes, Shoag, Jonathan, Sheyn, David, Lengu, Irma
Format: Article
Language:English
Subjects:
Cohort Studies
Complications
Creatinine
Cross-Sectional Studies
Humans
Kidney diseases
Kidney Neoplasms - complications
Kidney Neoplasms - surgery
Medicine
Medicine & Public Health
Minimally invasive surgery
Minimally Invasive Surgical Procedures
Morbidity
Mortality
Nephrectomy
Nephrectomy - methods
Nephrology
Patients
Postoperative
Postoperative Complications - epidemiology
Preoperative Period
Quality control
Renal Insufficiency, Chronic - complications
Retrospective Studies
Statistical analysis
Surgery
Treatment Outcome
Urology
Urology - Original Paper
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Summary:Purpose To assess the impact of preoperative chronic kidney disease (CKD) on perioperative morbidity and mortality in a contemporary cohort undergoing renal surgery in an era of increased prevalence of minimally invasive surgery and partial nephrectomy. Methods The National Surgery Quality Improvement Program dataset was queried to identify patients undergoing radical nephrectomy (RN) or partial nephrectomy (PN) between 2010 and 2018. CKD staging was assigned based on creatinine clearance calculated using the Cockcroft-Gault formula. Multivariable logistic regression was performed to assess the effect of preoperative CKD stage on postoperative outcomes, including a composite variable encompassing multiple major complications. Results We analyzed 19,545 patients with CKD undergoing renal surgery. CKD stage ≥ 2 predicted an increase in major perioperative complications, OR 1.54 (95% CI 1.46–1.63); p   2 also demonstrated increased 30-day mortality, OR 1.87 (95% CI 1.26–2.48); p  
ISSN:0301-1623
1573-2584
DOI:10.1007/s11255-021-03068-2