External validation of the Palacios' equation: a simple and accurate tool to estimate the new baseline renal function after renal cancer surgery.
World J Urol
; 40(2): 467-473, 2022 Feb.
Article
em En
| MEDLINE
| ID: mdl-34825945
ABSTRACT
PURPOSE:
To externally validate the Palacios' equation estimating the new baseline glomerular filtration rate (NB-GFR) after partial or radical-nephrectomy (PN, RN) for Renal cancer carcinoma (RCC). MATERIALS ANDMETHODS:
Our research group recently published two studies that investigated the association between renal function and cancer-specific survival in RCC. The first one included 3457 patients undergone RN or PN for a cT1-2 RCC coming from five high-volume centers; the second one considered 1767 patients undergone RN or PN for a cT1-4 RCC in a single high-volume center. From such datasets, available complete patients' data were used to calculate the predicted NB-GFR through the Palacios' equation predicted NB-GFR = 35.03 + 0.65 â preoperative GFR - 18.19 â (if radical nephrectomy) - 0.25 â age + 2.83 â (if tumor size > 7 cm) - 2.09 â (if diabetes). The observed NB-GFR was calculated by the CKD-EPI equation on serum creatinine at 3-12 months after surgery. Concordance between observed and predicted NB-GFR was evaluated by Lin's concordance correlation coefficient and Bland-Altman analysis.RESULTS:
2419 patients were included (1210, cohort #1; 1219, cohort #2). The median observed NB-GFR value in cohorts #1 and #2 was 73.0 ml/min/1.73 m2 (IQR 56.1-90.1) and 64.2 ml/min/1.73 m2 (IQR 49.6-83); the median predicted NB-GFR was 71.1 ml/min/1.73 m2 (IQR 58-81.5) and 62.6 ml/min/1.73m2 (IQR 47.9-75.9). The concordance line showed a slope of 0.80 and 0.86, and an intercept at 11.02 and 5.41 ml/min/1.73 m2 in the cohort#1 and #2, respectively. The Palacio's equation moderately over-estimated and under-estimated NB-GFR, for values below and above the cut-off of 50 ml/min/1.73 m2 and 35 ml/min/1.73m2 in cohort#1 and #2. The Lin's concordance correlation coefficient was 0.79 (95% CI 0.77-0.81) and 0.83 (95% CI 0.82-0.85).CONCLUSIONS:
We confirm the predictive performances of Palacios' equation, supporting its utilization in clinical practice.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Insuficiência Renal Crônica
/
Neoplasias Renais
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Child, preschool
/
Humans
Idioma:
En
Revista:
World J Urol
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Itália