PROGNOSTIC FACTORS OF ACUTE KIDNEY INJURY AFTER SOLITARY KIDNEY PARTIAL NEPHRECTOMY
Objective. To determine the acute kidney injury prognostic factors after partial nephrectomy for renal masses in the solitary kidney.
Materials and methods. One hundred and twenty five patients with solitary kidneys managed with in situ open partial nephrectomy at the Oncourology Department of the N. N. Alexandrov National Cancer Centre of Belarus were examined in August, 2000 up to April, 2016.
Results. A multifactor logistic regression revealed that the maximum tumor size odds ratio (ОR) 2.2; 95% CI (1.2—4.6), p=0.023) was the strongest predictor of acute kidney injury after the solitary kidney in situ open partial nephrectomy when warm ischemia was used. The strongest predictors of acute kidney injury for patients after partial nephrectomy with cold ischemia were determined to be multifocality (ОR 6.8; 95% CI (1.4—41.8), p=0.023) as well as the baseline serum potassium (ОR 28.9; 95% CI (3.5—463.5), p=0.006).
Conclusion. The retrospective comparative study suggests that development of acute kidney injury after partial nephrectomy of the solitary kidney during warm ischemia is strongly associated with the tumour size while during the cold ischemia the multifocality and the baseline serum potassium are associated with acute kidney injury significantly. The study outcomes showed that the ischemia duration did not lead to a significant reduction of the renal function in the early postoperative period.