肾部分切除术后肾功能变化情况观察

王刚; 李宁忱; 果宏峰; 那彦群

doi:10.13201/j.issn.1001-1420.2015.03.004

肾部分切除术后肾功能变化情况观察

- 1 北京大学首钢医院泌尿外科, 北京大学吴阶平泌尿外科医学中心(北京, 100144)

详细信息

通讯作者: 李宁忱,E-mail:ningchenli@126.com

中图分类号: R737.11

收稿日期: 2014-05-31

Renal function before and after partial nephrectomy

- Department of Urology, Peking University Shougang Hospital, Peking University Wujieping Urology Medical Center, Beijing, 100144, China

More Information

Corresponding author: LI Ningchen, E-mail: ningchenli@126.com

Received Date: 31 May 2014

摘要

摘要: 目的:了解肾肿瘤行肾部分切除术后肾功能的变化情况。方法:2010年1月~2013年5月施行肾部分切除术61例,采集患者年龄、性别、体质指数(body mass index,BMI)、伴随疾病(高血压、糖尿病、冠心病)、肿瘤的病理类型、采用简化MDRD公式计算出的eGFR、右肾小球滤过率(rGFR)及术后3~6个月的eGFR,分析术前及术后肾功能变化情况及相关因素。结果:术前肾功能Ⅰ级68%,Ⅱ级25%,Ⅲ级7%。21%患者术后肾功能恶化至中度肾功能损伤(Ⅲ级及以上),与患者年龄(OR=0.985,P=0.039)、术前肾功能水平即eGFR(OR=1.328,P=0.002)、肾动脉阻断时间(OR=0.913,P=0.037)、肿瘤直径(OR=0.996,P=0.011)相关。结论:患者增加的年龄、术前肾功能水平、肾动脉阻断时间以及肿瘤直径是术后出现肾功能恶化至中度肾功能损伤(Ⅲ级及以上)的独立危险因素。
- 肾肿瘤 /
- 肾部分切除术 /
- 肾功能
Abstract: Objective:To evaluate the renal function before and after partial nephrectomy.Method:We retrospectively reviewed the records of 61 patients treated with partial nephrectomy for renal tumor including patients' age, sex, BMI, concomitant diseases and pathologic characteristics. The abbreviated Modification of Diet in Renal Disease (MDRD) equation was used to calculate estimate glomerular filtration rate (eGFR). Multivariate logistic regression models tested the association of newly acquired chronic kidney disease stage Ⅲ or greater with pertinent demographic, tumor and surgical factors.Result:At baseline 68%, 25% and 7% of patients had chronic kidney disease stage Ⅰ, Ⅱ and Ⅲ, respectively. Over the follow-up period of 3-6 months 21% of patients progressed to chronic kidney disease stage Ⅲ or greater. Increasing age(OR=0.985, P=0.039), lower preoperative eGFR (OR=1.328, P=0.002), clamping time of renal artery (OR=0.913, P=0.037), increasing tumor size (OR=0.996, P=0.011) were independently associated with newly acquired chronic kidney disease stage III or greater.Conclusion:Chronic kidney disease stage Ⅲ or greater will develop postoperatively in 21% of patients, and this progression is associated with increasing age, preoperative renal function, clamping time of renal artery and tumor diameter.
- kidney neoplasms /
- partial nephrectomy /
- kidney function

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