Session: MP58: Kidney Cancer: Localized: Surgical Therapy III
MP58-16: Significance of glucose control for perioperative and long-term renal functions after nephron-sparing surgery for renal cancer in patients with diabetes
Introduction: This study aimed to evaluate the predictive factors for perioperative and long-term renal functions after nephron-sparing surgery (NSS). Methods: The clinical records of 379 patients who underwent NSS for a single renal tumor with a normal contralateral kidney between 2009 and 2016 were retrospectively analyzed. After surgery, the occurrence of acute kidney injury (AKI) within 7 days and the progression of chronic kidney disease (CKD) 5 years later were assessed using serum creatinine (S-Cr) levels. Perioperative AKI was defined as an increase in the S-Cr level by = 0.3 mg/dL or 1.5–1.9 times the baseline value. CKD was defined as the estimated glomerular filtration rate (eGFR) decreasing from > 60 mL/min/1.73 m2 to < 60 mL/min/1.73 m2. Results: Changes in the eGFR were assessed during 5 years after surgery. Among 379 patients, 81 (21.4%) patients presented diabetes mellitus (DM), and 30 (7.92%) experienced uncontrolled DM. The AKI occurrence and CKD progression were observed in 50 (13.2%) patients and 79 (20.8%) patients, respectively. Multivariate analyses revealed that female gender (odds ratio [OR] = 0.39, 95% confidence interval [CI]: 0.16–0.91, p=0.029), uncontrolled DM (OR = 2.63, 95% CI: 1.05–6.60, p=0.039), and intermediate NePhRO score (OR = 2.02, 95% CI: 1.07–3.80, p=0.03) were associated with perioperative AKI. In addition, old age (OR = 1.14, 95% CI: 1.10–1.18, p<0.001) and uncontrolled DM (OR = 4.57, 95% CI: 1.84–11.4, p=0.001) were associated with long-term CKD progression. Conclusions: Uncontrolled DM is the only predictive factor for perioperative and long-term renal functions after nephron-sparing surgery. SOURCE OF Funding: None.
