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Impact of postoperative acute kidney injury on predicting the upstaging of chronic kidney disease after robot‐assisted partial nephrectomy
Author(s) -
Teishima Jun,
Inoue Shogo,
Miyamoto Shunsuke,
Fukuoka Kenichiro,
Sekino Yohei,
Kitano Hiroyuki,
Hieda Keisuke,
Hayashi Tetsutaro,
Matsubara Akio
Publication year - 2021
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12829
Subject(s) - medicine , renal function , acute kidney injury , nephrectomy , kidney disease , creatinine , perioperative , surgery , urology , stage (stratigraphy) , kidney , paleontology , biology
Abstract Introduction The aim of our study was to assess the impact of acute kidney injury (AKI) on postoperative upstaging of chronic kidney disease (CKD) after robot‐assisted partial nephrectomy (RAPN). Methods This study consisted of 110 patients who had undergone RAPN and were followed up for at least 6 months after surgery. Patients were classified as AKI or non‐AKI based on their serum creatinine level and estimated glomerular filtration rate within 7 days after surgery. Patient characteristics, outcome of RAPN and estimated glomerular filtration rate, and CKD upstage 6 months after surgery were compared between the AKI and non‐AKI groups. Results A total of 26 patients (23.6%) experienced AKI after surgery. RENAL (radius, exophytic/endophitic properties, nearness of the tumor to the collecting system or sinus, anterior/posterior, location relative to the polar lines) nephrometry scores were ≥7 for 22 (84.6%) in the AKI group and 39 (46.4%) in the non‐AKI group ( P = .0006). A significantly smaller proportion of patients in the AKI group than in the non‐AKI group recovered 90% of baseline function (38.5% vs 81.0%, P < .0001). CKD upstaging occurred in a total of 27 patients 24.5%) and in a significantly larger proportion of patients in the AKI group than in the non‐AKI group (42.3% vs 19.0%, P = .0160). There was no significant difference in characteristics and perioperative outcomes between the patients with and without CKD, except for in those experiencing AKI. Conclusion After RAPN, AKI can be associated with CKD upstaging.