TY  - JOUR
A1  - Wenzel, Mike
A1  - Yu, Hang
A1  - Uhlig, Annemarie
A1  - Würnschimmel, Christoph
A1  - Wallbach, Manuel
A1  - Becker, Andreas
A1  - Fisch, Margit
A1  - Chun, Felix
A1  - Meyer, Christian P.
A1  - Leitsmann, Marianne
T1  - Cystatin C predicts renal function impairment after partial or radical tumor nephrectomy
T2  - International urology and nephrology
N2  - 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.
KW  - Cystatin C
KW  - Nephrectomy
KW  - Renal cell carcinoma
KW  - GFR
KW  - Acute kidney injury
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/63702
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-637023
SN  - 1573-2584
N1  - Open Access funding enabled and organized by Projekt DEAL.
VL  - 53
IS  - 10
SP  - 2041
EP  - 2049
PB  - Springer Science + Business Media B.V.
CY  - Dordrecht [u.a.]
ER  -