Background: Hypertension (HTN) is a global public health issue. There are limited data regarding the effects of HTN in patients undergoing partial nephrectomy (PN) for renal tumors. To address this void, we tested the association between HTN and renal function after minimally invasive PN (MIPN). Methods: Using a multi-institutional database (2007–2017), we identified patients aged ≥ 18 years with a diagnosis of cT1 renal tumors treated with MIPN. Kaplan–Meier plots and Cox regression models addressed newly-onset CKD stage ≥ 3b or higher (sCKD). All analyses were repeated after 1:1 propensity score matching (PSM). Results: Overall, 2144 patients were identified. Of those, 35% (n = 759) were yes-HTN. Yes-HTN patients were older, more frequently male and more often presented with diabetes. Yes-HTN patients harbored higher RENAL nephrometry scores and higher cT stages than no-HTN patients. Conversely, yes-HTN patients exhibited lower preoperative eGFRs. In the overall cohort, five-year sCKD-free survival was 86% vs. 94% for yes-HTN vs. no-HTN, which translated into a multivariable HR of 1.67 (95% CI: 1.06–2.63, p = 0.026). After 1:1 PSM, virtually the same results were observed (HR 1.86, 95% CI: 1.07–3.23, p = 0.027). Conclusions: Yes-HTN patients exhibited worse renal function after MIPN when compared to their no-HTN counterparts. However, these observations need to be further tested in a prospective cohort study.

Is hypertension associated with worse renal functional outcomes after minimally invasive partial nephrectomy? Results from a multi-institutional cohort / Flammia, ROCCO SIMONE; Anceschi, Umberto; Tufano, Antonio; Tuderti, Gabriele; Ferriero, MARIA CONSIGLIA; Brassetti, Aldo; Mari, Andrea; Di Maida, Fabrizio; Minervini, Andrea; Derweesh, Ithaar H.; Capitanio, Umberto; Larcher, Alessandro; Montorsi, Francesco; Eun, Daniel; Lee, Jennifer; Luciani, Lorenzo G.; Cai, Tommaso; Malossini, Gianni; Veccia, Alessandro; Autorino, Riccardo; Fiori, Cristian; Porpiglia, Francesco; Gallucci, Michele; Leonardo, Costantino; Simone, Giuseppe. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - (2022). [10.3390/jcm11051243]

Is hypertension associated with worse renal functional outcomes after minimally invasive partial nephrectomy? Results from a multi-institutional cohort

Rocco Simone Flammia;Umberto Anceschi
;
Antonio Tufano;gabriele tuderti;Maria Consiglia Ferriero;Aldo Brassetti;Michele Gallucci;Costantino Leonardo;
2022

Abstract

Background: Hypertension (HTN) is a global public health issue. There are limited data regarding the effects of HTN in patients undergoing partial nephrectomy (PN) for renal tumors. To address this void, we tested the association between HTN and renal function after minimally invasive PN (MIPN). Methods: Using a multi-institutional database (2007–2017), we identified patients aged ≥ 18 years with a diagnosis of cT1 renal tumors treated with MIPN. Kaplan–Meier plots and Cox regression models addressed newly-onset CKD stage ≥ 3b or higher (sCKD). All analyses were repeated after 1:1 propensity score matching (PSM). Results: Overall, 2144 patients were identified. Of those, 35% (n = 759) were yes-HTN. Yes-HTN patients were older, more frequently male and more often presented with diabetes. Yes-HTN patients harbored higher RENAL nephrometry scores and higher cT stages than no-HTN patients. Conversely, yes-HTN patients exhibited lower preoperative eGFRs. In the overall cohort, five-year sCKD-free survival was 86% vs. 94% for yes-HTN vs. no-HTN, which translated into a multivariable HR of 1.67 (95% CI: 1.06–2.63, p = 0.026). After 1:1 PSM, virtually the same results were observed (HR 1.86, 95% CI: 1.07–3.23, p = 0.027). Conclusions: Yes-HTN patients exhibited worse renal function after MIPN when compared to their no-HTN counterparts. However, these observations need to be further tested in a prospective cohort study.
2022
Hypertension; kidney neoplasm; robot-assisted partial nephrectomy
01 Pubblicazione su rivista::01a Articolo in rivista
Is hypertension associated with worse renal functional outcomes after minimally invasive partial nephrectomy? Results from a multi-institutional cohort / Flammia, ROCCO SIMONE; Anceschi, Umberto; Tufano, Antonio; Tuderti, Gabriele; Ferriero, MARIA CONSIGLIA; Brassetti, Aldo; Mari, Andrea; Di Maida, Fabrizio; Minervini, Andrea; Derweesh, Ithaar H.; Capitanio, Umberto; Larcher, Alessandro; Montorsi, Francesco; Eun, Daniel; Lee, Jennifer; Luciani, Lorenzo G.; Cai, Tommaso; Malossini, Gianni; Veccia, Alessandro; Autorino, Riccardo; Fiori, Cristian; Porpiglia, Francesco; Gallucci, Michele; Leonardo, Costantino; Simone, Giuseppe. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - (2022). [10.3390/jcm11051243]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1619553
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