Estimated Glomerular Filtration Rate Decline at 1 Year After Minimally Invasive Partial Nephrectomy: A Multimodel Comparison of Predictors.
Publication/Presentation Date
4-1-2022
Abstract
BACKGROUND: Long-term renal function after partial nephrectomy (PN) is difficult to predict as it is influenced by several modifiable and nonmodifiable variables, often intertwined in complex relations.
OBJECTIVE: To identify variables influencing long-term renal function after PN and to assess their relative weight.
DESIGN SETTING AND PARTICIPANTS: A total of 457 patients who underwent either robotic (
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The 1-yr estimated glomerular filtration rate (eGFR) percentage loss (1YPL), defined as the eGFR percentage change from baseline at 1 yr after surgery, was the outcome endpoint. Predictors evaluated included demographic data, tumor features, and operative and postoperative variables. Bayesian multimodel analysis of covariance was used to build all possible models and compare the fit of each model to the data via model Bayes factors. Bayesian model averaging was used to quantify the support for each predictor via the inclusion Bayes factor (BF
RESULTS AND LIMITATIONS: Several models were found to be plausible for estimation of 1YPL. The best model, comprising postoperative eGFR percentage loss (PPL), sex, ischemia technique, and preoperative eGFR, was 207 times more likely than all the other models regarding relative predictive performance. Its components were part of the top 44 models and were the predictors with the highest BF
CONCLUSIONS: Preoperative eGFR, sex, ischemia technique, and PPL are the best predictors of eGFR percentage loss at 1 yr after minimally invasive PN. Other predictors seem to be irrelevant, as their influence is insignificant or already nested in the effect of these four parameters.
PATIENT SUMMARY: Kidney function at 1 year after partial removal of a kidney depends on sex, the technique used to halt blood flow to the kidney during surgery, and kidney function at baseline and in the early postoperative period.
Volume
38
First Page
52
Last Page
59
ISSN
2666-1683
Published In/Presented At
Crocerossa, F., Fiori, C., Capitanio, U., Minervini, A., Carbonara, U., Pandolfo, S. D., Loizzo, D., Eun, D. D., Larcher, A., Mari, A., Grosso, A. A., Di Maida, F., Hampton, L. J., Cantiello, F., Damiano, R., Porpiglia, F., & Autorino, R. (2022). Estimated Glomerular Filtration Rate Decline at 1 Year After Minimally Invasive Partial Nephrectomy: A Multimodel Comparison of Predictors. European urology open science, 38, 52–59. https://doi.org/10.1016/j.euros.2022.02.005
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
35495283
Department(s)
Administration and Leadership
Document Type
Article