Outcome of kidney function after ischaemic and zero-ischaemic laparoscopic and open nephron-sparing surgery for renal cell cancer

Ebbing, Jan; Menzel, Felix; Frumento, Paolo; Miller, Kurt; Ralla, Bernhard; Fuller, Tom Florian; Busch, Jonas; Collins, Justin William; Adding, Christofer; Seifert, Hans Helge; Ardelt, Peter; Wetterauer, Christian; Westhoff, Timm; Kempkensteffen, Carsten

doi:10.1186/s12882-019-1215-3

Table 3 Absolute and relative (%) changes in eGFR

From: Outcome of kidney function after ischaemic and zero-ischaemic laparoscopic and open nephron-sparing surgery for renal cell cancer

Cohort/ subgroup	Measurement time A (1 [1–2] day p.o.)	Measurement time B (4 [2–6] days p.o.)	Measurement time C (47 [30–105] days p.o.)	Measurement time D (13 [12–15] months p.o.)	Measurement time E (50 [35–81] months p.o.)	p-value
NSS-C	−16.8 [−27.0 - −7.9]	−9.9 [−19.1–0.0]	−9.1 [−23.2–0.0]	−7.8 [−20.4–0.25]	−10.4 [−20.2 - −1.2]	< 0.001
n = 444 (100.0%)	−22.6% [−36.2% - −9.7%]	−13.0% [−24.9%–0.0%]	−12.5% [−27.2%–0.0%]	−11.0% [−26.3%–0.3%]	−14.1% [−27.7% - −1.3%]	< 0.001^*
n = 444 (100.0%)	n = 436 (98.2%)	n = 436 (98.2%)	n = 184 (41.4%)	n = 203 (45.7%)	n = 234 (52.7%)	< 0.001^*
NSS-RI	− 17.7 [− 27.8 - −9.1]	−10.2 [− 19.8 - −1.2]	−9.7 [− 23.8–0.1]	−8.6 [−21.0–0.6]	−10.0 [− 19.6–0.67]	< 0.001
n = 343 (100.0%)	− 24.0% [− 38.0% - −10.9%]	− 13.7% [− 25.5%- −1.5%]	− 19.3% [− 37.2%–5.5%]	− 15.8% [− 35.3%–6.1%]	− 11.5% [− 33.4%–9.8%]	< 0.001^*
n = 343 (100.0%)	n = 337 (98.3%)	n = 337 (98.3%)	n = 148 (43.1%)	n = 161 (46.9%)	n = 183 (53.4%)	< 0.001^*
NSS-NRI	−12.6 [− 23.8–1.3]	−4.7 [− 17.5–4.7]	−1.9 [− 21.9–5.7]	−6.6 [− 14.0–2.6]	− 12.1 [− 25.7 - −1.2]	0.15
n = 57 (100.0%)	− 17.5% [−31.9%–2.1%]	− 7.4% [− 21.3%–9.5%]	−2.9% [− 25.0%–6.6%]	− 9.4% [− 22.7%–5.3%]	− 14.8% [− 44.5% - −1.4%]	0.15^*
n = 57 (100.0%)	n = 57 (100.0%)	n = 57 (100.0%)	n = 25 (43.9%)	n = 28 (49.1%)	n = 34 (59.6%)	0.15^*
p-value	0.01	0.03	0.1	0.43	0.28
p-value	0.007^*	0.01^*	0.07^*	0.35^*	0.13^*
LNSS-RI	−13.3 [− 25.3 - −7.1]	−8.0 [− 17.5–0.0]	−7.7 [− 23.4 - −0.4]	−7.4 [− 20.1 - −1.0]	−9.0 [− 18.4 - −0.1]	< 0.001
n = 185 (100.0%)	− 17.0% [−30.5% - −9.0%]	− 10.1% [− 21.6%–0.0%]	− 10.5% [− 27.7% - −0.5%]	− 10.8% [− 23.0% - −1.3%]	− 9.8% [− 23.4%–1.8%]	< 0.001^*
n = 185 (100.0%)	n = 183 (98.9%)	n = 183 (98.9%)	n = 76 (41.0%)	n = 90 (48.6%)	n = 102 (55.1%)	< 0.001^*
ONSS-RI	−22.8 [− 31.0 - −13.2]	− 13.7 [− 22.1 - −4.1]	−11.5 [− 24.2–0.0]	−10.7 [− 23.4 - −0.3]	− 12.6 [− 23.7 - −2.0]	< 0.001
n = 158 (100.0%)	− 31.1% [− 44.1% - −18.5%]	− 19.8% [−29.9% - −6.1%]	− 16.2% [−28.0% - −16.2%]	− 15.9% [−32.5% - −0.3%]	− 14.7% [− 30.3% - −2.9%]	< 0.001^*
n = 158 (100.0%)	n = 154 (97.5%)	n = 154 (97.5%)	n = 72 (45.6%)	n = 71 (44.9%)	n = 81 (51.6%)	< 0.001^*
p-value	< 0.001	< 0.001	0.58	0.49	0.06
p-value	< 0.001^*	< 0.001^*	0.45^*	0.37^*	0.06^*
NSS-AKI	−27.7 [−36.8 - −23.3]	− 17.3 [− 26.6 - −11.7]	−16.4 [− 25.9 - − 4.5]	−13.8 [− 24.0 - −5.2]	−14.7 [− 24.5 - −5.4]	< 0.001
n = 126 (100.0%)	−37.5% [− 46.8% - −30.9%]	− 25.2% [− 32.4% - −15.2%]	− 22.4% [−34.0% - −7.7%]	− 22.7% [− 33.5% - −10.2%]	− 21.6% [− 31.0% - −8.8%]	< 0.001^*
n = 126 (100.0%)	n = 126 (100.0%)	n = 126 (100.0%)	n = 60 (47.6%)	n = 65 (51.5%)	n = 68 (53.9%)	< 0.001^*
NSS-NAKI	−9.8 [− 16.8- −1.6]	−3.4 [− 10.4–4.9]	−5.0 [− 14.0–2.0]	−5.0 [− 13.5–2.0]	−7.2 [− 17.3–3.0]	< 0.001
n = 201 (100.0%)	− 12.1% [− 20.1% - −1.8%]	− 4.2% [− 13.3% - −6.8%]	− 6.8% [− 17.1%–3.4%]	− 6.6% [− 18.3%–2.6%]	− 9.4% [− 21.2%–4.4%]	0.004^*
n = 201 (100.0%)	n = 201 (100.0%)	n = 201 (100.0%)	n = 80 (39.8%)	n = 92 (45.8%)	n = 109 (54.2%)	0.004^*
p-value	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001
p-value	< 0.001^*	< 0.001^*	< 0.001^*	< 0.001^*	< 0.001^*
NSS-G1	− 18.0 [− 32.7 - −7.5]	− 10.9 [− 24.4 - −0.6]	−20.4 [− 30.3 - − 5.4]	−10.3 [− 31.0 - − 0.5]	−13.0 [− 31.9 - − 4.9]	0.04
n = 134 (100.0%)	− 19.5% [− 30.6% - −7.4%]	− 10.6% [− 22.9% - −0.7%]	− 21.0% [− 28.7% - −5.7%]	− 10.6% [− 29.8% - −0.1%]	− 13.2% [− 29.8% - −5.1%]	0.04^*
n = 134 (100.0%)	n = 133 (99.0%)	n = 133 (99.0%)	n = 42 (31.3%)	n = 46 (34.3%)	n = 62 (46.3%)	0.04^*
NSS-G2	−17.8 [− 27.6 - −8.6]	−10.4 [− 18.0 - −1.1]	−9.7 [− 22.7 - − 0.1]	−10.0 [− 21.5 - − 0.3]	−10.2 [− 19.6 - − 0.7]	< 0.001
n = 223 (100.0%)	− 24.5% [− 36.5% - −11.0%]	− 13.4% [− 24.5% - −1.2%]	− 12.3% [− 27.2% - −0.1%]	− 12.5% [− 27.2% - −0.4%]	− 14.1% [− 24.0% - −0.9%]	< 0.001^*
n = 223 (100.0%)	n = 221 (99.0%)	n = 221 (99.0%)	n = 104 (46.6%)	n = 120 (53.8%)	n = 131 (58.7%)	< 0.001^*
NSS ≥ G3	−13.6 [− 22.8 - −3.4]	−5.1 [− 13.9–1.3]	−3.4 [− 9.1–2.4]	− 4.8 [− 10.6–2.1]	−7.2 [− 15.3–0.9]	< 0.001
n = 82 (100.0%)	− 29.3% [− 46.4% - −9.3%]	− 13.5% [− 29.3%–4.1%]	− 7.9% [− 17.1% - 7.4%]	− 9.0% [− 22.0%–4.6%]	− 14.7% [− 29.9%–1.8%]	< 0.001^*
n = 82 (100.0%)	n = 82 (100.0%)	n = 82 (100.0%)	n = 38 (46.3%)	n = 37 (45.1%)	n = 42 (51.2%)	< 0.001^*
p-value	0.02	0.007	< 0.001	0.03	0.02
p-value	0.004^*	0.78^*	0.03^*	0.43^*	0.6^*

Absolute and relative (%) changes in eGFR from baseline for the overall NSS cohort (NSS-C) and for different subgroups at different postoperative median measurement times (A-E)
Subgroups: NSS cohort with intraoperative renal ischaemia (NSS-RI), NSS cohort without intraoperative renal ischaemia (NSS-NRI), LNSS with intraoperative renal ischaemia (LNSS-RI), ONSS cohort with intraoperative renal ischaemia (ONSS-RI), NSS cohort with development of postoperative AKI (NSS-AKI), NSS cohort without development of postoperative AKI (NSS-NAKI), NSS cohort with baseline eGFR category G1 (NSS-G1), NSS cohort with baseline eGFR category G2 (NSS-G2), and NSS cohort with baseline eGFR category ≥ G3 (NSS ≥ G3)
Estimated glomerular filtration rate (eGFR) values were calculated according to the MDRD (Modification of Diet in Renal Disease) formula. Data are shown as median and interquartile range [IQR]
NSS nephron-sparing surgery, LNSS laparoscopic nephron-sparing surgery, ONSS open nephron-sparing surgery, n numbers investigated, p.o. postoperative
^*P-values refer to relative (%) values

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