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Prediction of partial nephrectomy outcomes by using the diameter‐axis‐polar nephrometry score
Author(s) -
Maeda Motohiro,
Funahashi Yasuhito,
Sassa Naoto,
Fujita Takashi,
Majima Tsuyoshi,
Gotoh Momokazu
Publication year - 2014
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12356
Subject(s) - medicine , renal function , nephrectomy , urology , creatinine , kidney , effective renal plasma flow , radioisotope renography , renal tumor , univariate analysis , renal blood flow , surgery , multivariate analysis
Objectives To evaluate the utility of diameter‐axis‐polar nephrometry score to evaluate partial nephrectomy outcomes. Methods Renal tumors of 127 patients with a functional contralateral kidney who underwent partial nephrectomy were scored using the diameter‐axis‐polar and R . E . N . A . L nephrometry scores. The mean tumor diameter was 2.9 cm (range 1.0–8.0 cm) and warm ischemic time was 27.3 min (range 12–46 min). All patients underwent 99m T c‐ mercaptoacetyltriglycine renal scintigraphy preoperatively and 6 months postoperatively to assess effective renal plasma flow. We compared nephrometry scores with estimated glomerular filtration rate, effective renal plasma flow and ischemic time. Results The mean serum creatinine level was 0.84 mg/d L preoperatively and 0.93 mg/d L at 6 months postoperatively. The mean estimated glomerular filtration rate decreased from 74.2 to 66.9 m L /min/1.73 m 2 . Effective renal plasma flow of the operated kidney decreased to 73.5% from baseline (from 157.0 to 114.3 m L /min/1.73 m 2 ). Univariate and multivariate analyses showed that diameter‐axis‐polar score had a stronger association with the percent change in estimated glomerular filtration rate, effective renal plasma flow in the treated kidney and ischemia time compared with the R . E . N . A . L score. Conclusions Diameter‐axis‐polar nephrometry score is a useful tool for the assessment of small renal tumors amenable to partial nephrectomy, and it better predicts postoperative functional changes and ischemic time compared with the R . E . N . A . L nephrometry score.