- 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.
MetadatenVerfasserangaben: | Mike WenzelORCiDGND, Hang YuGND, Annemarie UhligORCiDGND, Christoph WürnschimmelORCiDGND, Manuel WallbachORCiD, Andreas BeckerGND, Margit FischGND, Felix ChunORCiDGND, Christian P. MeyerGND, Marianne Leitsmann |
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URN: | urn:nbn:de:hebis:30:3-637023 |
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DOI: | https://doi.org/10.1007/s11255-021-02957-w |
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ISSN: | 1573-2584 |
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Titel des übergeordneten Werkes (Englisch): | International urology and nephrology |
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Verlag: | Springer Science + Business Media B.V. |
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Verlagsort: | Dordrecht [u.a.] |
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Dokumentart: | Wissenschaftlicher Artikel |
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Sprache: | Englisch |
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Datum der Veröffentlichung (online): | 16.07.2021 |
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Datum der Erstveröffentlichung: | 16.07.2021 |
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Veröffentlichende Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Datum der Freischaltung: | 13.04.2023 |
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Freies Schlagwort / Tag: | Acute kidney injury; Cystatin C; GFR; Nephrectomy; Renal cell carcinoma |
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Jahrgang: | 53 |
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Ausgabe / Heft: | 10 |
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Seitenzahl: | 9 |
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Erste Seite: | 2041 |
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Letzte Seite: | 2049 |
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Bemerkung: | Open Access funding enabled and organized by Projekt DEAL. |
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HeBIS-PPN: | 508902223 |
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Institute: | Medizin |
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DDC-Klassifikation: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Lizenz (Deutsch): | Creative Commons - Namensnennung 4.0 |
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