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C-index is associated with functional outcomes after laparoscopic partial nephrectomy.

Publication ,  Journal Article
Samplaski, MK; Hernandez, A; Gill, IS; Simmons, MN
Published in: J Urol
December 2010

PURPOSE: The C-index is a morphometric descriptor of renal masses that incorporates tumor size and site. We examined associations of the C-index with kidney function after laparoscopic partial nephrectomy. MATERIALS AND METHODS: We retrospectively reviewed the records of 131 patients who underwent laparoscopic partial nephrectomy for a single kidney tumor. We calculated the C-index from preoperative contrast enhanced computerized tomography images. Estimated glomerular filtration rate was calculated using the modification of diet in renal disease 2 equation. Nadir estimated glomerular filtration rate was calculated using peak serum creatinine within 7 days of surgery. RESULTS: The median C-index was 2.7 (range 0.7 to 9.6). The median preoperative and nadir estimated glomerular filtration rate was 78 (range 23 to 148) and 54 ml/minute/1.73 m2 (range 15 to 127, p<0.001). The mean±SD total glomerular filtration rate decrease was 28%±16%. On univariate analysis we noted a positive correlation between log C-index and the nadir estimated glomerular filtration rate (r=0.29, p=0.002), and a negative correlation between log C-index and the percent decrease in the estimated glomerular filtration rate (r=-0.4, p<0.001). On multivariate analysis the estimated glomerular filtration rate percent decrease was significantly associated with log C-index (p=0.005) and warm ischemia time (p<0.001) but not with tumor diameter or the preoperative estimated glomerular filtration rate. Of patients with a C-index of 2.5 or less 70% showed a 30% or greater decrease in the estimated glomerular filtration rate vs 32% of those with a C-index of greater than 2.5 (RR 2.2, p<0.001). CONCLUSIONS: The C-index is associated with the postoperative nadir estimated glomerular filtration rate and the percent decrease in the estimated glomerular filtration rate after laparoscopic partial nephrectomy. A C-index of less than 2.5 correlated with a 2.2-fold increased risk of a 30% or greater estimated glomerular filtration rate decrease after laparoscopic partial nephrectomy.

Duke Scholars

Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

December 2010

Volume

184

Issue

6

Start / End Page

2259 / 2263

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Retrospective Studies
  • Nephrectomy
  • Middle Aged
  • Male
  • Laparoscopy
  • Kidney Neoplasms
  • Humans
  • Glomerular Filtration Rate
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Samplaski, M. K., Hernandez, A., Gill, I. S., & Simmons, M. N. (2010). C-index is associated with functional outcomes after laparoscopic partial nephrectomy. J Urol, 184(6), 2259–2263. https://doi.org/10.1016/j.juro.2010.08.031
Samplaski, Mary K., Adrian Hernandez, Inderbir S. Gill, and Matthew N. Simmons. “C-index is associated with functional outcomes after laparoscopic partial nephrectomy.J Urol 184, no. 6 (December 2010): 2259–63. https://doi.org/10.1016/j.juro.2010.08.031.
Samplaski MK, Hernandez A, Gill IS, Simmons MN. C-index is associated with functional outcomes after laparoscopic partial nephrectomy. J Urol. 2010 Dec;184(6):2259–63.
Samplaski, Mary K., et al. “C-index is associated with functional outcomes after laparoscopic partial nephrectomy.J Urol, vol. 184, no. 6, Dec. 2010, pp. 2259–63. Pubmed, doi:10.1016/j.juro.2010.08.031.
Samplaski MK, Hernandez A, Gill IS, Simmons MN. C-index is associated with functional outcomes after laparoscopic partial nephrectomy. J Urol. 2010 Dec;184(6):2259–2263.
Journal cover image

Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

December 2010

Volume

184

Issue

6

Start / End Page

2259 / 2263

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Retrospective Studies
  • Nephrectomy
  • Middle Aged
  • Male
  • Laparoscopy
  • Kidney Neoplasms
  • Humans
  • Glomerular Filtration Rate