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The Impact of Body Mass Index on Renal Functional Outcomes Following Minimally Invasive Partial Nephrectomy.
MedLine Citation:
PMID:  24935823     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective: To assess the impact of body mass index (BMI) on perioperative and renal functional outcomes in patients undergoing minimally invasive partial nephrectomy. Materials and Methods: In our IRB-approved, prospectively maintained clinical database, we identified 1,206 patients who underwent kidney surgery from 2002-2013. Estimated glomerular filtration rate (eGFR) was obtained at baseline and each follow-up visit. From this group, patients that underwent minimally invasive partial nephrectomy (MIPN) with more than 12 months of follow up were selected. Patients were separated into 4 cohorts based on BMI: normal weight (<25 kg/m<sup>2</sup>), pre-obese (25-30 kg/m<sup>2</sup>), obese class 1 (30-35 kg/m<sup>2</sup>), and obese class ≥ 2 (>35 kg/m<sup>2</sup>). Change in eGFR was compared across demographic and clinical variables via linear and logistic regression models. Results: A total of 235 patients met inclusion criteria with median follow-up of 29 months [IQR 19, 45]. There were no differences in demographic, perioperative, or pathologic features between BMI groups. While controlling for gender, race, CCI, tumor size, and ischemia time, obese class 1 (OR 4.68, p=0.019), obese class ≥ 2 (OR 4.27, p=0.033) and age (OR 1.06, p=0.014) were associated with increased risk of CKD stage ≥ 3; however, higher baseline eGFR (OR 0.91, p<0.001) was associated with a reduced risk of CKD stage ≥ 3. While controlling for the same variables, increasing BMI was associated with a significant absolute reduction in eGFR at one year (0.38 mL/min/1.73 m<sup>2</sup> reduction in GFR per 1 kg/m<sup>2</sup> increase in BMI, p = 0.009). Conclusions: MIPN is technically feasible in obese patients with similar perioperative outcomes to non-obese patients. BMI is an independent risk factor for worsening kidney function following MIPN.
Authors:
Kyle A Richards; Edris Negron; Joshua A Cohn; Zoe Steinberg; Scott E Eggener; Arieh Shalhav
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-16
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  -     ISSN:  1557-900X     ISO Abbreviation:  J. Endourol.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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