Effect of war mische mia ti me on long-ter m postoperative renal function after partial nephrecto my in solitary ki dney

Sascha Pahernik; Zhu Jie; Wei Yingqi; Zeier Martin; Gencay Hatiboglu; Gita Schoenberg; Timur Kuru; Tobias Simpfendrfer; Zhang Xu; Markus Hohenfellner

Abstract：The effects of war mische mia time on long-ter mrenal functi on after partial nephrecto my re-main controversial .Our aim was to evaluate the effect of war mische mia time on long-term renal function after par-tial nephrecto my .Methods :A retrospective study was performed on 75 patients undergoing 83 procedures of partial nephrecto my in Department of Urol ogy of Clinical Center of University Hei del berg from 08/1984 to 07/2011 .The effects of war mische mia time ,preoperative renal function and resected normal parenchy mavolu me on long-term re-nal function in patients with a solitary kidney were eval uated .Results :Mean preoperative e GFR was 57.41 mL/(min per 1.73 m2 .Mean ische mia time was 1 8.04 min .Mean volume of resected normal parenchy ma was 1 8.79cm3 . Mean follow- up time was 69.39 months .On multi variable analysis ,adjusting for age and comorbi dities factors ,pre-operative renal function baseline was significantly associated with renal function at 1 2th month postoperati on (P=0.01 ).Peri operative ARF event significantly affected postoperati ve renal function at 12th month on (P =0.001 )and 60th month (P =0.03 )postoperati on .Warm ische mia time and resected normal parenchy ma volume were not risk factors of long-term postoperative renal function .The peri operative ARF event was significantly associated with renal;function change at 12th month postoperation (P<0.01).Only resected volume of normal parenchy ma was signifi-cantly associated with renal function change during whole follow- up period (P =0.03 at 12th month ,and P<0.01 at 36th and 60th month ).Conclusions :The quality and quantity of kidney were mosti mportant risk factors of long-term renal function after partial nephrecto my .The quality of preoperative kidney primarily deter mines long-term postoperative renal function .Additi onally ,the quantity of preserved functional parenchy ma volume was the main de-ter minant for long-term kidney recovery .Moreover ,the acute renal failure was an independent risk factor influencing both recovery capacity and renal function level in long-term postoperative duration .Further more ,WIT was indirectly associated with postoperative renal function leading to a hi gher rate of peri operative acute renal failure .