Mp44-05 Parenchymal Volume Analysis to Assess Longitudinal Functional Decline and Atrophy After Pn

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy III (MP44)1 May 2024MP44-05 PARENCHYMAL VOLUME ANALYSIS TO ASSESS LONGITUDINAL FUNCTIONAL DECLINE AND ATROPHY AFTER PN Carlos Munoz-Lopez, Kieran Lewis, Worapat Attawettayanon, Eran Maina, João P. Emrich Accioly, Nityam Rathi, Zaeem Lone, Rebecca A. Campbell, Jihad Kaouk, Georges P. Haber, Mohamad Eltemamy, Venkatesh Krishnamurthi, Robert Abouassaly, Christopher Weight, and Steven C. Campbell Carlos Munoz-LopezCarlos Munoz-Lopez , Kieran LewisKieran Lewis , Worapat AttawettayanonWorapat Attawettayanon , Eran MainaEran Maina , João P. Emrich AcciolyJoão P. Emrich Accioly , Nityam RathiNityam Rathi , Zaeem LoneZaeem Lone , Rebecca A. CampbellRebecca A. Campbell , Jihad KaoukJihad Kaouk , Georges P. HaberGeorges P. Haber , Mohamad EltemamyMohamad Eltemamy , Venkatesh KrishnamurthiVenkatesh Krishnamurthi , Robert AbouassalyRobert Abouassaly , Christopher WeightChristopher Weight , and Steven C. CampbellSteven C. Campbell View All Author Informationhttps://doi.org/10.1097/01.JU.0001009508.69111.d0.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prior studies suggest that the average kidney loses≈0.8*/year or≈0.4*/year/kidney due to aging. Some have suggested that ischemia leaves the kidney vulnerable to atrophy and longitudinal functional decline following clamped PN; however, studies regarding this are limited. We sought to identify factors associated with longitudinal ipsilateral functional decline after PN. METHODS: Of 1,140 PN patients (2012-14), 349 (31%) had imaging/SCr pre PN, 1-12 months post PN (new baseline), and≥3 years later necessary for inclusion. Parenchymal volume analysis was used to estimate SRF. Patients were grouped as having significant renal comorbidity (CohortSRC: diabetes with insulin dependence or end organ damage, refractory hypertension, or severe preexisting CKD) versus not having these preoperatively (CohortNoSRC). Multivariable regression was used to identify predictors of annual ipsilateral parenchymal atrophy and functional decline relative to new baseline values post PN, after the kidney has healed. RESULTS: Median follow-up was 6.3 years with 87/226/36 patients having cold/warm/zero ischemia. Median cold/warm ischemia times were 32/22 minutes. Overall, median tumor size was 3.0 cm. Preoperative GFR and NBGFR were 81 and 71*, respectively. After establishment of NBGFR, median loss of global/ipsilateral function was 0.7*/0.4*/year, respectively, consistent with natural aging. Overall, median ipsilateral atrophy was 1.2 cm3/year and accounted for a median of 53% of annual functional decline. Significant renal comorbidity, age and warm ischemia independently associated with ipsilateral atrophy (all p<0.01). Significant renal comorbidity and ipsilateral atrophy independently associated with annual ipsilateral functional decline (both p<0.01). Annual median ipsilateral parenchymal atrophy and functional decline were both increased for CohortSRC vs CohortNoSRC (2.8 vs 0.9 cm3, p<0.01 and 0.90 vs 0.30*/year, p<0.01, respectively). CONCLUSIONS: Longitudinal renal function following PN generally follows the normal aging process. Significant renal comorbidities, age, warm ischemia, and ipsilateral atrophy were the most important predictors of ipsilateral functional decline following establishment of NBGFR. *ml/min/1.73 m2. Download PPT Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e731 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Carlos Munoz-Lopez More articles by this author Kieran Lewis More articles by this author Worapat Attawettayanon More articles by this author Eran Maina More articles by this author João P. Emrich Accioly More articles by this author Nityam Rathi More articles by this author Zaeem Lone More articles by this author Rebecca A. Campbell More articles by this author Jihad Kaouk More articles by this author Georges P. Haber More articles by this author Mohamad Eltemamy More articles by this author Venkatesh Krishnamurthi More articles by this author Robert Abouassaly More articles by this author Christopher Weight More articles by this author Steven C. Campbell More articles by this author Expand All Advertisement PDF downloadLoading ...