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Hydronephrosis severity as a predictor of postoperative renal function decline following laparoscopic radical nephroureterectomy
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 rat...
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| Published in: | International journal of clinical oncology 2024-04, Vol.29 (4), p.464-472 |
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| container_end_page | 472 |
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| container_start_page | 464 |
| container_title | International journal of clinical oncology |
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| creator | 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 |
| description | 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 |
| doi_str_mv | 10.1007/s10147-024-02468-5 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2922947501</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2983851153</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-d31621c212195e1630ffef20f5dafd53d29b71407b784bc454955d636fbce57b3</originalsourceid><addsrcrecordid>eNp9kUtv1TAQRi1URB_wB1ggS2zYpHj8iJMlqqCtVIkNrC3HHhdXuXGwk6K760_HlxSQuujCsiWfOTOjj5C3wM6BMf2xAAOpG8bl4bRdo16QE5BCN1prflTfQkLTt1wdk9NS7hgD3Sr-ihyLTkCrgZ2Qh6u9z2nC-UdOJRZa8B5zXPbUFmrpnNFHt6RMU6BzKkuaMdsl3iPNONmRhnVyS0wT9ejGOCENaRzTrzjd0tHOtjpdmqOj2VZP5bdGa8YFM1bxbv-avAx2LPjm8T4j3798_nZx1dx8vby--HTTOMHbpfF1YA6OA4deIbSChYCBs6C8DV4Jz_tBg2R60J0cnFSyV8q3og2DQ6UHcUY-bN45p58rlsXsYnE4jnbCtBbDe857qRWDir5_gt7Vkeu6B6oTnQJQolJ8o1zdsmQMZs5xZ_PeADOHfMyWj6nZmD_5GFWL3j2q12GH_l_J30AqIDag1K_pFvP_3s9ofwPv154v</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2983851153</pqid></control><display><type>article</type><title>Hydronephrosis severity as a predictor of postoperative renal function decline following laparoscopic radical nephroureterectomy</title><source>Springer Nature</source><creator>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</creator><creatorcontrib>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</creatorcontrib><description>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 < 0.001). Multivariate analysis revealed that factors predictive of postoperative eGFR included sex, preoperative eGFR, clinical T stage (cT3–4), and the presence of moderate or severe hydronephrosis. Our predictive model, based on these factors, positively correlated with actual postoperative renal function, and the similarity in categories with or without renal function insufficiency between predicted and actual postoperative renal functions was 78% in both training and validation sets.
Conclusion
Moderate or severe hydronephrosis is associated with a modest postoperative decline in renal function, while mild hydronephrosis is not. Our predictive model may be useful in predicting postoperative renal function insufficiency and guiding decision-making for perioperative medical treatment.</description><identifier>ISSN: 1341-9625</identifier><identifier>EISSN: 1437-7772</identifier><identifier>DOI: 10.1007/s10147-024-02468-5</identifier><identifier>PMID: 38316710</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>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</subject><ispartof>International journal of clinical oncology, 2024-04, Vol.29 (4), p.464-472</ispartof><rights>The Author(s) under exclusive licence to Japan Society of Clinical Oncology 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s) under exclusive licence to Japan Society of Clinical Oncology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-d31621c212195e1630ffef20f5dafd53d29b71407b784bc454955d636fbce57b3</cites><orcidid>0000-0001-9445-4035</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38316710$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kanno, Toru</creatorcontrib><creatorcontrib>Kobori, Go</creatorcontrib><creatorcontrib>Saito, Ryoichi</creatorcontrib><creatorcontrib>Ito, Katsuhiro</creatorcontrib><creatorcontrib>Nakagawa, Hiromichi</creatorcontrib><creatorcontrib>Takahashi, Toshifumi</creatorcontrib><creatorcontrib>Koterazawa, Shigeki</creatorcontrib><creatorcontrib>Takaoka, Naoto</creatorcontrib><creatorcontrib>Somiya, Shinya</creatorcontrib><creatorcontrib>Haitani, Takao</creatorcontrib><creatorcontrib>Nagahama, Kanji</creatorcontrib><creatorcontrib>Ito, Masaaki</creatorcontrib><creatorcontrib>Higashi, Yoshihito</creatorcontrib><creatorcontrib>Moroi, Seiji</creatorcontrib><creatorcontrib>Akao, Toshiya</creatorcontrib><creatorcontrib>Yamada, Hitoshi</creatorcontrib><title>Hydronephrosis severity as a predictor of postoperative renal function decline following laparoscopic radical nephroureterectomy</title><title>International journal of clinical oncology</title><addtitle>Int J Clin Oncol</addtitle><addtitle>Int J Clin Oncol</addtitle><description>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 < 0.001). Multivariate analysis revealed that factors predictive of postoperative eGFR included sex, preoperative eGFR, clinical T stage (cT3–4), and the presence of moderate or severe hydronephrosis. Our predictive model, based on these factors, positively correlated with actual postoperative renal function, and the similarity in categories with or without renal function insufficiency between predicted and actual postoperative renal functions was 78% in both training and validation sets.
Conclusion
Moderate or severe hydronephrosis is associated with a modest postoperative decline in renal function, while mild hydronephrosis is not. Our predictive model may be useful in predicting postoperative renal function insufficiency and guiding decision-making for perioperative medical treatment.</description><subject>Cancer Research</subject><subject>Decision making</subject><subject>Epidermal growth factor receptors</subject><subject>Glomerular filtration rate</subject><subject>Hydronephrosis</subject><subject>Laparoscopy</subject><subject>Medical treatment</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate analysis</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Prediction models</subject><subject>Renal function</subject><subject>Statistical analysis</subject><subject>Surgical Oncology</subject><issn>1341-9625</issn><issn>1437-7772</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kUtv1TAQRi1URB_wB1ggS2zYpHj8iJMlqqCtVIkNrC3HHhdXuXGwk6K760_HlxSQuujCsiWfOTOjj5C3wM6BMf2xAAOpG8bl4bRdo16QE5BCN1prflTfQkLTt1wdk9NS7hgD3Sr-ihyLTkCrgZ2Qh6u9z2nC-UdOJRZa8B5zXPbUFmrpnNFHt6RMU6BzKkuaMdsl3iPNONmRhnVyS0wT9ejGOCENaRzTrzjd0tHOtjpdmqOj2VZP5bdGa8YFM1bxbv-avAx2LPjm8T4j3798_nZx1dx8vby--HTTOMHbpfF1YA6OA4deIbSChYCBs6C8DV4Jz_tBg2R60J0cnFSyV8q3og2DQ6UHcUY-bN45p58rlsXsYnE4jnbCtBbDe857qRWDir5_gt7Vkeu6B6oTnQJQolJ8o1zdsmQMZs5xZ_PeADOHfMyWj6nZmD_5GFWL3j2q12GH_l_J30AqIDag1K_pFvP_3s9ofwPv154v</recordid><startdate>20240401</startdate><enddate>20240401</enddate><creator>Kanno, Toru</creator><creator>Kobori, Go</creator><creator>Saito, Ryoichi</creator><creator>Ito, Katsuhiro</creator><creator>Nakagawa, Hiromichi</creator><creator>Takahashi, Toshifumi</creator><creator>Koterazawa, Shigeki</creator><creator>Takaoka, Naoto</creator><creator>Somiya, Shinya</creator><creator>Haitani, Takao</creator><creator>Nagahama, Kanji</creator><creator>Ito, Masaaki</creator><creator>Higashi, Yoshihito</creator><creator>Moroi, Seiji</creator><creator>Akao, Toshiya</creator><creator>Yamada, Hitoshi</creator><general>Springer Nature Singapore</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9445-4035</orcidid></search><sort><creationdate>20240401</creationdate><title>Hydronephrosis severity as a predictor of postoperative renal function decline following laparoscopic radical nephroureterectomy</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-d31621c212195e1630ffef20f5dafd53d29b71407b784bc454955d636fbce57b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Cancer Research</topic><topic>Decision making</topic><topic>Epidermal growth factor receptors</topic><topic>Glomerular filtration rate</topic><topic>Hydronephrosis</topic><topic>Laparoscopy</topic><topic>Medical treatment</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multivariate analysis</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Prediction models</topic><topic>Renal function</topic><topic>Statistical analysis</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kanno, Toru</creatorcontrib><creatorcontrib>Kobori, Go</creatorcontrib><creatorcontrib>Saito, Ryoichi</creatorcontrib><creatorcontrib>Ito, Katsuhiro</creatorcontrib><creatorcontrib>Nakagawa, Hiromichi</creatorcontrib><creatorcontrib>Takahashi, Toshifumi</creatorcontrib><creatorcontrib>Koterazawa, Shigeki</creatorcontrib><creatorcontrib>Takaoka, Naoto</creatorcontrib><creatorcontrib>Somiya, Shinya</creatorcontrib><creatorcontrib>Haitani, Takao</creatorcontrib><creatorcontrib>Nagahama, Kanji</creatorcontrib><creatorcontrib>Ito, Masaaki</creatorcontrib><creatorcontrib>Higashi, Yoshihito</creatorcontrib><creatorcontrib>Moroi, Seiji</creatorcontrib><creatorcontrib>Akao, Toshiya</creatorcontrib><creatorcontrib>Yamada, Hitoshi</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kanno, Toru</au><au>Kobori, Go</au><au>Saito, Ryoichi</au><au>Ito, Katsuhiro</au><au>Nakagawa, Hiromichi</au><au>Takahashi, Toshifumi</au><au>Koterazawa, Shigeki</au><au>Takaoka, Naoto</au><au>Somiya, Shinya</au><au>Haitani, Takao</au><au>Nagahama, Kanji</au><au>Ito, Masaaki</au><au>Higashi, Yoshihito</au><au>Moroi, Seiji</au><au>Akao, Toshiya</au><au>Yamada, Hitoshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hydronephrosis severity as a predictor of postoperative renal function decline following laparoscopic radical nephroureterectomy</atitle><jtitle>International journal of clinical oncology</jtitle><stitle>Int J Clin Oncol</stitle><addtitle>Int J Clin Oncol</addtitle><date>2024-04-01</date><risdate>2024</risdate><volume>29</volume><issue>4</issue><spage>464</spage><epage>472</epage><pages>464-472</pages><issn>1341-9625</issn><eissn>1437-7772</eissn><abstract>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 < 0.001). Multivariate analysis revealed that factors predictive of postoperative eGFR included sex, preoperative eGFR, clinical T stage (cT3–4), and the presence of moderate or severe hydronephrosis. Our predictive model, based on these factors, positively correlated with actual postoperative renal function, and the similarity in categories with or without renal function insufficiency between predicted and actual postoperative renal functions was 78% in both training and validation sets.
Conclusion
Moderate or severe hydronephrosis is associated with a modest postoperative decline in renal function, while mild hydronephrosis is not. Our predictive model may be useful in predicting postoperative renal function insufficiency and guiding decision-making for perioperative medical treatment.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>38316710</pmid><doi>10.1007/s10147-024-02468-5</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-9445-4035</orcidid></addata></record> |
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| source | Springer Nature |
| 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 |
| title | Hydronephrosis severity as a predictor of postoperative renal function decline following laparoscopic radical nephroureterectomy |
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