Pelvic exenteration associated with future renal dysfunction
Pelvic exenteration associated with future renal dysfunction
复制标题
DOI：
10.1007/s00595-020-02036-0
复制
发表时间：
2020-06
期刊：
影响因子：
2.5
通讯作者：
Masanori Sando;K. Uehara;Yuanying Li;T. Aiba;A. Ogura;T. Ebata;Y. Kodera;H. Yatsuya;M. Nagino
中科院分区：
文献类型：
--
作者：
Masanori Sando;K. Uehara;Yuanying Li;T. Aiba;A. Ogura;T. Ebata;Y. Kodera;H. Yatsuya;M. Nagino
PurposeThis study aims to clarify the long-term change in the renal function after pelvic exenteration（PE）and to evaluate the risk factors for any future dysfunction.MethodsThis study included 40 patients.超过25%的估计肾小球滤过率（eGFR）在3年下降被定义为早期肾功能障碍（ERFD），可能预测未来的慢性肾脏病（CKD）。结果在整个队列中，中位eGFR下降23%，在3年，和CKD发展为50%。将患者分为ERFD组（n= 16）和非ERFD组（n= 24）。在ERFD组中，eGFR在前1.5年内显著下降28%，之后继续下降，导致81.3%的患者达到CKD，而在非ERFD组中分别为4%和37.5%。在生长模型分析中，晚期尿路并发症（UTC）和小肠梗阻被证明是ERFD.ConclusionAlthough PE与未来CKD的高发病率，ERFD可以预测it. Close观察eGFR下降超过1.5年可能是有益的，以确定ERFD患者的危险因素。因此，应仔细观察晚期UTC和小肠梗阻的高危患者。
PurposeThis study aimed to clarify the long-term change in the renal function after pelvic exenteration (PE) and to evaluate the risk factors for any future dysfunction.MethodsThis study comprised 40 patients. A greater than 25% decline in the estimated glomerular filtration rate (eGFR) at 3 years was defined as early renal function disorder (ERFD), possibly predicting future chronic kidney disease (CKD).ResultsIn the entire cohort, the median eGFR decreased by 23% at 3 years, and CKD developed in 50%. The patients were divided into the ERFD (n= 16) and non-ERFD (n= 24) groups. In the ERFD group, the eGFR significantly decreased by 28% during the first 1.5 years and continued to decline after that, resulting in 81.3% of patients reaching CKD, whereas it was 4% and 37.5%, respectively, in the non-ERFD group. In a growth model analysis, late urinary tract complications (UTC) and small bowel obstruction were shown to be risk factors for ERFD.ConclusionAlthough PE was associated with a high incidence of future CKD, ERFD could predict it. Close observation of the eGFR decline over 1.5 years might be beneficial to identify ERFD patients. High-risk patients with late UTC and small bowel obstruction should, therefore, be observed carefully.