Song et al identified risk factors affecting the reduction in renal function of a kidney that has been subjected to a partial nephrectomy. The impact of this loss in renal function may be significant if the patient has a solitary kidney. The authors are from the University of Ulsan at the Asan Medical Center in Seoul, Korea.


Patient selection: renal tumor amenable to partial nephrectomy


Factors associated with a greater reduction in renal function in the affected kidney:

(1) increasing age

(2) greater percent of kidney resection

(3) resection of the upper pole of the kidney


The ages of patients ranged from 26 to 75 years of age. The beta for age (from Table 4, page 51) was 0.29. In the implementation an age > 60 will be used to represent increasing age. A younger patient might have more parenchymal hyperplasia which would compensate for the tissue removed.


The greater the amount of kidney resected the greater the reduction in glomerular filtration rate. Most cases showed a volume reduction from 15 to 40%; a reduction greater than 50% is difficult for a partial nephrectomy. (The line equation reported in the caption on page 52 does not match the line in Figure A. An estimate for the line in the figure is y = 1.25 * x rather than y = 0.582 * x + 18.356).


The authors found that outcomes following laparoscopic surgery were similar to those of an open procedure.


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