ArticleEuropean urology2022
What Happens to the Preserved Renal Parenchyma After Clamped Partial Nephrectomy?
Article in European urology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- The impact of warm ischemia time on short-term renal function after partial nephrectomy: a systematic review and meta-analysis.BMC urology · 2025Pooled it
- Comparison of the perioperative outcomes of robot-assisted laparoscopic transperitoneal versus retraperitoneal partial nephrectomy for posterior-lateral renal tumors: a systematic review and meta-analysis.Journal of robotic surgery · 2024Pooled it
- The role of warm ischemia time on functional outcomes after robotic partial nephrectomy: a radionuclide renal scan study from the clock randomized trial.World journal of urology · 2023Trial
- Targeting a Novel AREGCell proliferation · 2026Article
- Beyond traditional nephrometry: a 3D quantitative framework for predicting pentafecta and evaluating mediation effects in nephron-sparing surgery.BMC urology · 2026Article
- Multimodal deep learning model for AI-based functional prognostic risk stratification in patients undergoing radical nephrectomy.Nature communications · 2026Article
- Gut symbiont-derived ursodeoxycholic acid promotes fatty acid oxidation to protect against renal ischemia-reperfusion injury.Cell reports. Medicine · 2025Article
- Article
- Functional outcomes in robot-assisted partial nephrectomy with three-dimensional images reconstructed from computed tomography: a propensity score-matched comparative analysis.Journal of robotic surgery · 2024Article
- Tracing the evolving dynamics and research hotspots in the kidney neoplasm and nephron sparing surgery field from the past to the new era.Cancer medicine · 2024Article
- Serum uric acid level is associated with glomerular ischemic lesions in patients with primary membranous nephropathy: an analytical, cross-sectional study.Scientific reports · 2024Article
- Transperitoneal vs. Retroperitoneal Approach in Laparoscopic Partial Nephrectomy for Posterior Renal Tumors: A Retrospective, Multi-Center, Comparative Study.Journal of clinical medicine · 2024Article
- Comparison of the efficacy of robotic-assisted retroperitoneal laparoscopy and traditional retroperitoneal laparoscopy in partial nephrectomy among patients with renal tumors: A retrospective cohort study.Investigative and clinical urology · 2023Article
- A new machine-learning model to predict long-term renal function impairment after minimally invasive partial nephrectomy: the Fundació Puigvert predictive model.World journal of urology · 2023Article
- Can the Abdominal Aortic Atherosclerotic Plaque Index Predict Functional Outcomes after Robot-Assisted Partial Nephrectomy?Diagnostics (Basel, Switzerland) · 2023Article
- Long-term effect of acute ischemic injury on the kidney underwent clamped partial nephrectomy.iScience · 2023Article
- Limited non-linear impact of warm ischemia time on renal functional decline after partial nephrectomy: a propensity score-matched study.International urology and nephrology · 2023Article
- Ultrasound-guided percutaneous intracystic deroofing is effective in the treatment of simple renal cysts.American journal of translational research · 2023Article
- Round up.Indian journal of urology : IJU : journal of the Urological Society of IndiaArticle
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Authors and funding
41 authors at 15 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost partial nephrectomies (PNs) are performed with hilar occlusion to reduce blood loss and optimize visualization. However, the histologic status of the preserved renal parenchyma years after PN is unknown.
objectiveTo compare the histologic chronic kidney disease (CKD) score of renal parenchyma before and years after PN, and to explore factors associated with CKD-score increase and glomerular filtration rate (GFR) decline. DESIGN, SETTING, AND
participantsA retrospective review of 147 renal cell carcinoma patients who underwent PN and subsequent radical nephrectomy (RN) due to tumor recurrence was performed in 19 Chinese centers and Cleveland Clinic. Macroscopic normal renal parenchyma was evaluated at least 5 mm away from the tumor in PN specimens and at remote sites in RN specimens.
interventionPN/RN and ischemia. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Histologic CKD score (0-12) represents a summary of glomerular/tubular/interstitial/vascular status. Predictive factors for a substantial increase of CKD score (≥3) were evaluated by logistic regression. RESULTS AND LIMITATIONS: Sixty-five patients with all necessary data were analyzed. The median interval between PN and RN was 2.4 yr. Median durations of warm ischemia (n = 42) and hypothermia (n = 23) were both 23 min. The histologic CKD score was increased after RN in 47 (72%) patients, with 29 (45%) experiencing more substantial increase (≥3). There was no significant difference in the change of CKD score related to the type and duration of ischemia (p = 0.7 and p = 0.4, respectively) or interval from PN to RN (p > 0.9). However, patients with comorbidities of hypertension, diabetes, and/or pre-existing CKD (hypertension [HTN]/diabetes mellitus [DM]/CKD) demonstrated increased rate and extent of CKD-score increase. On univariate analysis, HTN/DM/CKD was the only predictor of a substantial CKD-score increase (odds ratio: 3.53 [1.12-11.1]). Decline of GFR was modest and similar between patients with/without a substantial CKD-score increase.
conclusionsWithin the context of conventional, limited durations of ischemia, histologic deterioration of preserved parenchyma after PN appears to be primarily due to pre-existing medical comorbidities rather than ischemia. A subsequent decline in renal function was mild and independent of histologic changes. PATIENT SUMMARY: After clamped PN, the preserved renal parenchyma demonstrated histologic deterioration in many cases, which correlated with the presence of comorbidities such as hypertension, diabetes mellitus, or chronic kidney disease. In contrast, the type and duration of ischemia did not correlate with histologic changes after PN, suggesting that ischemia insult had only limited impact on parenchyma deterioration.
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