1. Incident Chronic Kidney Disease After Radical Nephrectomy for Renal Cell Carcinoma
- Author
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Glenda C. Gobe, Damien M Bolton, David J. T. Marco, Michael D. Coory, Ian D. Davis, Anne Kay, D Bolton, Michael Coory, G.G. Giles, John F. Seymour, Ross S Francis, Miles Prince, Robert J. Ellis, Ian Roos, Gianlucca Severi, Simon Wood, Victoria White, Jeremy Millar, Ingrid Winship, Melissa C. Southey, Graham G. Giles, Victoria M. White, Susan J. Jordan, Simon J. Harrison, David J. Hill, Rachel E. Neale, and Michael Jefford
- Subjects
Male ,Rural Population ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Population ,030232 urology & nephrology ,Renal function ,Nephrectomy ,03 medical and health sciences ,0302 clinical medicine ,Renal cell carcinoma ,Internal medicine ,medicine ,Humans ,Registries ,Renal Insufficiency, Chronic ,education ,Carcinoma, Renal Cell ,Aged ,Retrospective Studies ,education.field_of_study ,business.industry ,Incidence ,Australia ,Retrospective cohort study ,Odds ratio ,medicine.disease ,Kidney Neoplasms ,Logistic Models ,Oncology ,030220 oncology & carcinogenesis ,Female ,business ,Kidney cancer ,Kidney disease - Abstract
Background Chronic kidney disease (CKD) after surgery for kidney cancer is common, and is associated with increased morbidity and mortality. This study aimed to identify factors associated with incident CKD in patients managed with radical nephrectomy. Patients and Methods All patients diagnosed with renal cell carcinoma between January 2012 and December 2013 were ascertained from state-based cancer registries in Queensland and Victoria. Information on patient, tumor, and health service characteristics was obtained via chart review. Multivariable logistic regression was used to evaluate exposures associated with incident CKD (estimated glomerular filtration rate [eGFR] Results Older age (adjusted odds ratio [aOR] per 5-year increase, 1.5; 95% confidence interval [CI], 1.4-1.6), male sex (aOR, 1.4; 95% CI, 1.0-2.0), obese compared with not obese (aOR, 1.8; 95% CI, 1.2-2.7), rural compared with urban place of residence (aOR, 1.8; 95% CI, 1.1-3.0) were associated with a higher risk of incident CKD. Lower preoperative eGFR was also associated with a higher risk of incident CKD. Management in private compared with public hospitals was also associated with a higher risk of CKD (aOR, 1.6; 95% CI, 1.2-2.2). Factors related to tumor size and cancer severity were also associated with worse postoperative kidney function, although it is likely this was a consequence of selection bias. Conclusion Patient characteristics have the strongest associations with incident CKD after radical nephrectomy. Potential risk factors were reasonably similar to recognized CKD risk factors for the general population. Patients who undergo nephrectomy who have CKD risk factors might benefit from ongoing postoperative screening for deterioration of kidney function.
- Published
- 2018