Hydronephrosis severity as a predictor of postoperative renal function decline following laparoscopic radical nephroureterectomy

• Published in: International journal of clinical oncology 2024-04, Vol.29 (4), p.464-472
• Main Authors: Kanno, Toru, Kobori, Go, Saito, Ryoichi, Ito, Katsuhiro, Nakagawa, Hiromichi, Takahashi, Toshifumi, Koterazawa, Shigeki, Takaoka, Naoto, Somiya, Shinya, Haitani, Takao, Nagahama, Kanji, Ito, Masaaki, Higashi, Yoshihito, Moroi, Seiji, Akao, Toshiya, Yamada, Hitoshi
• Format: Article
• Language: English
• Subjects: Cancer Research; Decision making; Epidermal growth factor receptors; Glomerular filtration rate; Hydronephrosis; Laparoscopy; Medical treatment; Medicine; Medicine & Public Health; Multivariate analysis; Oncology; Original Article; Patients; Prediction models; Renal function; Statistical analysis; Surgical Oncology
• ISSN: 1341-9625; 1437-7772
• DOI: 10.1007/s10147-024-02468-5

Background This study aimed to investigate factors, including the degree of hydronephrosis, that may be associated with decreased renal function after radical nephroureterectomy (RNU). Methods This study included 252 patients who underwent laparoscopic RNU with an estimated glomerular filtration rate (eGFR) ≥ 30 ml/min/1.73 m 2 in three institutions. We assessed the association between hydronephrosis grade and perioperative renal function and performed a stepwise multivariate linear regression analysis to identify factors associated with postoperative eGFR. Patients with preoperative eGFR ≥ 50 ml/min/1.73 m 2 were divided into a training set and an independent external validation set to develop a predictive model for postoperative renal function. Results The median preoperative and postoperative eGFR were 61.1 and 46.4 ml/min/1.73 m 2 , respectively. The eGFR preservation rates were 66.9%, 66.6%, 88.1%, and 100.0% in groups without, with mild, moderate, and severe hydronephrosis, respectively, and this difference was statistically significant (p