ArticleCanadian Urological Association journal = Journal de l'Association des urologues du Canada2021
Predictors of long-term renal function after kidney surgery for patients with preoperative chronic kidney disease.
Article in Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.
- Systematic review and meta-analysis of belatacept versus calcineurin inhibitors on risk of post-transplant diabetes mellitus in kidney transplant recipients.Frontiers in immunology · 2026Pooled it
- Prognostic factors and survival data in the management of upper tract urothelial carcinoma in solitary kidney patients.World journal of urology · 2025Article
- [Treatment of localized renal cell carcinoma].Urologie (Heidelberg, Germany) · 2024Article
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Authors and funding
12 authors at 1 institution in 2 countries.
Funding
Abstract
introductionWe evaluated the trajectory of estimated glomerular filtration rate (eGFR) after kidney surgery in patients with kidney cancer and chronic kidney disease (CKD).
methodsWe identified 1204 consecutive patients in our institutional database with preoperative CKD undergoing partial or radical nephrectomy from 1998-2016. Postoperative eGFR was tracked, with patients censored when receiving dialysis or kidney transplantation. A multivariable mixed-effects models assessed associations between preoperative baseline patient and tumor characteristics, and longitudinal eGFR. The Kaplan-Meier method and multivariable Cox regression were used to estimate overall survival, cancer-specific survival, and cumulative incidence of dialysis.
resultsPreoperatively, 892 (74.1%), 271 (22.5%), and 41 (3.4%) patients had CKD stage 3a, 3b, and 4/5, respectively. There were 55 patients dialyzed and 355 deaths (99 from kidney cancer). Median followup was 8.1 years, with 25 781 postoperative eGFR measurements. Factors associated with decreasing eGFR postoperatively included radical nephrectomy, male gender, older age, increased body mass index (BMI), and cardiovascular risk factors. We observed a significant interaction effect between time from surgery and preoperative CKD stage: the eGFR of stage 3a patients improved, while stage ≥3b declined (p<0.001). The two-year and five-year cumulative incidence of dialysis was 1.8% (1.1-2.6%) and 3.1% (2.2-4.2%), respectively. The cumulative incidence of dialysis, with death as a competing event, significantly differed by preoperative CKD stage.
conclusionsPreoperative CKD stage ≥3b is independently associated with a higher risk of declining renal function, dialysis, and mortality. With careful selection, patients with preoperative CKD withstand kidney surgery with low rates of dialysis.
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