Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Wenzel, M; Yu, H; Uhlig, A; Würnschimmel, C; Wallbach, M; Becker, A; Fisch, M; Chun, FKH; Meyer, CP; Leitsmann, M.
Cystatin C predicts renal function impairment after partial or radical tumor nephrectomy.
Int Urol Nephrol. 2021; 53(10): 2041-2049.
Doi: 10.1007/s11255-021-02957-w
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- Co-Autor*innen der Med Uni Graz
- Leitsmann Marianne
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- Abstract:
- PURPOSE: To test the value of preoperative and postoperative cystatin C (CysC) as a predictor on kidney function after partial (PN) or radical nephrectomy (RN) in renal cell carcinoma (RCC) patients with normal preoperative renal function. METHODS: From 01/2011 to 12/2014, 195 consecutive RCC patients with a preoperative estimated glomerular filtration rate (eGFR) > 60 ml/min/1.73m2 underwent surgical RCC treatment with either PN or RN. Logistic and linear regression models tested for the effect of CysC as a predictor of new-onset chronic kidney disease in follow-up (eGFR < 60 ml/min/1.73m2). Moreover, postoperative CysC and creatinine values were compared for kidney function estimation. RESULTS: Of 195 patients, 129 (66.2%) underwent PN. In postoperative and in follow-up setting (median 14 months, IQR 10-20), rates of eGFR < 60 ml/min/1.73m2 were 55.9 and 30.2%. In multivariable logistic regression models, preoperative CysC [odds ratio (OR): 18.3] and RN (OR: 13.5) were independent predictors for a reduced eGFR < 60 ml/min/1.73m2 in follow-up (both p < 0.01), while creatinine was not. In multivariable linear regression models, a difference of the preoperative CysC level of 0.1 mg/dl estimated an eGFR decline in follow-up of about 5.8 ml/min/1.73m2. Finally, we observed a plateau of postoperative creatinine values in the range of 1.2-1.3 mg/dl, when graphically depicted vs. postoperative CysC values ('creatinine blind area'). CONCLUSION: Preoperative CysC predicts renal function impairment following RCC surgery. Furthermore, CysC might be superior to creatinine for renal function monitoring in the early postoperative setting.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged - administration & dosage
- Carcinoma, Renal Cell - surgery
- Cystatin C - blood
- Female - administration & dosage
- Humans - administration & dosage
- Kidney Diseases - blood
- Kidney Neoplasms - surgery
- Male - administration & dosage
- Middle Aged - administration & dosage
- Nephrectomy - methods
- Postoperative Complications - blood
- Predictive Value of Tests - administration & dosage
- Retrospective Studies - administration & dosage
- Find related publications in this database (Keywords)
- Cystatin C
- Nephrectomy
- Renal cell carcinoma
- GFR
- Acute kidney injury