Characterization of mild and severe post-radical nephrectomy renal functional deterioration utilizing histopathological evaluation of non-neoplastic nephrectomized renal parenchyma.
Int J Clin Oncol
; 21(3): 588-94, 2016 Jun.
Article
en En
| MEDLINE
| ID: mdl-26450843
ABSTRACT
BACKGROUND:
We investigated factors affecting mild (MRFD) and severe renal functional deterioration (SRFD) after radical nephrectomy with a special focus on the histopathology of nephrectomized non-neoplastic renal parenchyma.METHODS:
MRFD was defined as a postoperative decline of percent estimated glomerular filtration rate (eGFR) lower than the value of the mean minus standard deviation (SD). SRFD was defined as a rate greater than the value of the mean plus SD. The histopathological factors of global glomerulosclerosis (GS) and arteriosclerosis in non-neoplastic renal parenchyma and multiple clinical factors were analyzed to determine whether they affected postoperative renal functional deterioration in 100 renal cell carcinoma cases. The prognoses, including non-cancer mortality, were collected from long-term follow-up data.RESULTS:
A higher preoperative eGFR and a higher global GS extent in non-neoplastic renal parenchyma were independently associated with MRFD and SRFD, respectively. The cardiovascular disease-specific survival rates of the SRFD group and the group with global GS extent >14 % were significantly worse than those of their counterparts.CONCLUSIONS:
This is the first report to identify global GS extent in nephrectomized non-neoplastic renal parenchyma as a factor affecting the development of life-threatening post-nephrectomy renal functional deterioration. Moreover, we are the first to advocate the importance of the characterization of favorable post-nephrectomy renal functional deterioration. The identification of MRFD and SRFD by histopathological evaluation of nephrectomized non-neoplastic renal parenchyma will contribute to personalized postoperative follow-up. It may improve follow-up of individual patients with SRFD by permitting collaboration with other clinical departments such as cardiology.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_cardiovascular_diseases
/
6_kidney_renal_pelvis_ureter_cancer
Asunto principal:
Carcinoma de Células Renales
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Enfermedades Cardiovasculares
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Insuficiencia Renal
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Glomerulonefritis
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Glomérulos Renales
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Neoplasias Renales
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Nefrectomía
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
Límite:
Adult
/
Aged
/
Aged80
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Int J Clin Oncol
Asunto de la revista:
NEOPLASIAS
Año:
2016
Tipo del documento:
Article
País de afiliación:
Japón