Effect of postoperative change of body mass index on renal function after laparoscopic partial nephrectomy
Wasilijiang Wahafu
Ma Xin
Zhang Xu
Li Hongzhao
Ding Qiang
Guo Gang
Shi Taoping
Wang Baojun
Abstract：Objective:To evaluate the effect of postoperative change of body mass index (BMI)on renal function after laparoscopic partial nephrectomy (LPN).Methods:A retrospective analysis on 204 patients who had undergone LPN by the same laparoscopic surgeon (Xu Zhang)in different follow-up periods (90 patients in one-year group,66 in three-year group,and 48 in five-year group)was performed.Patient demographics,tumor characteristics,opera-tive outcomes,and renal functions were compared.Univariate and multivariate analyses were performed to show pre-dicting factors for the change value of estimated glomerular filtration rates (eGFR).Results:The patients were fol-lowed up for a median period of 1 7 months in the one-year group,41.5 months in three-year group,and 65 months in the five-year group.There were no significant differences among the three groups with respect to patient demo-graphics,tumor characteristics,and perioperative outcomes.Although there were no differences observed in follow-up BMI (P = 0. 8 5 7 ),there were significant differences regarding BMI change value and ratio among the groups (P = 0. 0 0 8 and P = 0. 0 1 5 ).And there was a trend towards rising of BMI in the three groups (0. 5 9 ,0. 6 7 and 0.86 kg/m2 respectively).The one-year group had faster operative time (91.46 ± 25.57 ) min, (P =0.010),shorter warm ischemia time (1 7.81 ± 5.98)min,(P = 0.027 ),and less estimated blood loss (30.5 ± 28.86)mL,(P =0.021)than the other groups.Comparison of preoperative renal function did not show a statistical-ly significan difference among the three groups for serum creatinine (sCr)and eGFR;however,these effects reached statistically significant difference in sCr (P = 0.012 )and eGFR (P = 0.001 )during follow-up period,and the change trend in eGFR more obvious than in sCr.The five-year group showed a statistically significant difference com-pared with one-year/three-year groups in the change value of BMI (P =0.012/P =0.041 ),sCr (both P <0.001 ) and eGFR (both P < 0.001 ).Univariate analyses showed five-year group (P < 0.001 ),age (P = 0.003 ),BMI change value and ratio (P =0.026 and P =0.048),age-adjusted CCI (P =0.020),R.E.N.A.L.score (P =0.049), preoperative eGFR (P <0.001)and warm ischemia time (P =0.039)as statistically significant predictive factors for the eGFR change value.In contrast,multivariate analyses showed that only five-year group (P < 0.001 ),BMI change value (P =0.039)and preoperative eGFR (P <0.001)had a statistically significant predictive factor for the eGFR change value.Conclusions:The increase of BMI was associated with declines in kidney function in a cohort of LPN patients.Clinicians should vigilantly monitor and timely intervene in elevated body weight patients for evidence of early kidney function decline in the long-term follow-up after LPN.
Keywords：kidney neoplasmslaparoscopic partial nephrectomybody mass indexglomerular filtration rates
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 200-207 )