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Title: Incident Chronic Kidney Disease After Radical Nephrectomy for Renal Cell Carcinoma.
Austin Authors: Ellis, Robert J;White, Victoria M;Bolton, Damien M ;Coory, Michael D;Davis, Ian D;Francis, Ross S;Giles, Graham G;Gobe, Glenda C;Marco, David J T;Neale, Rachel E;Wood, Simon T;Jordan, Susan J
Affiliation: Translational Research Institute, Brisbane, Australia
Centre for Palliative Care, Melbourne, Australia
Cancer Council Victoria, Melbourne, Australia
Deakin University, Geelong, Australia
QIMR Berghofer Medical Research Institute, Brisbane, Australia
University of Melbourne, Melbourne, Australia
Austin Health, Heidelberg, Victoria, Australia
Monash University, Melbourne, Australia
Eastern Health, Melbourne, Australia
Princess Alexandra Hospital, Brisbane, Australia
University of Queensland, Brisbane, Australia
Issue Date: 15-Mar-2019 2019-03-15
Publication information: Clinical genitourinary cancer 2019; 17(3): e581-e591
Abstract: Chronic kidney disease (CKD) after surgery for kidney cancer is common, and is associated with increased morbidity and mortality. This study aimed to identify factors associated with incident CKD in patients managed with radical nephrectomy. All patients diagnosed with renal cell carcinoma between January 2012 and December 2013 were ascertained from state-based cancer registries in Queensland and Victoria. Information on patient, tumor, and health service characteristics was obtained via chart review. Multivariable logistic regression was used to evaluate exposures associated with incident CKD (estimated glomerular filtration rate [eGFR] <60 mL per minute per 1.73 m2) at 12 months after nephrectomy. Older age (adjusted odds ratio [aOR] per 5-year increase, 1.5; 95% confidence interval [CI], 1.4-1.6), male sex (aOR, 1.4; 95% CI, 1.0-2.0), obese compared with not obese (aOR, 1.8; 95% CI, 1.2-2.7), rural compared with urban place of residence (aOR, 1.8; 95% CI, 1.1-3.0) were associated with a higher risk of incident CKD. Lower preoperative eGFR was also associated with a higher risk of incident CKD. Management in private compared with public hospitals was also associated with a higher risk of CKD (aOR, 1.6; 95% CI, 1.2-2.2). Factors related to tumor size and cancer severity were also associated with worse postoperative kidney function, although it is likely this was a consequence of selection bias. Patient characteristics have the strongest associations with incident CKD after radical nephrectomy. Potential risk factors were reasonably similar to recognized CKD risk factors for the general population. Patients who undergo nephrectomy who have CKD risk factors might benefit from ongoing postoperative screening for deterioration of kidney function.
DOI: 10.1016/j.clgc.2019.02.011
ORCID: 0000-0002-5145-6783
Journal: Clinical genitourinary cancer
PubMed URL: 30975606
Type: Journal Article
Subjects: Chronic kidney disease
Glomerular filtration rate
Kidney cancer
Renal cell carcinoma
Appears in Collections:Journal articles

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