The effect of partial nephrectomy on blood pressure in patients with solitary kidney
4
Citation
18
Reference
10
Related Paper
Citation Trend
Keywords:
Nephrology
Kidney cancer
Background: Despite their potential benefits to patients, the adoption of partial nephrectomy and laparoscopic kidney cancer surgery has been both gradual and concentrated in select hospitals. Objective: We assessed the degree to which adjusting for hospital structural characteristics modifies the association between hospital nephrectomy volume and patient receipt of partial nephrectomy and/or laparoscopic kidney cancer surgery. Research Design and Subjects: From the Nationwide Inpatient Sample, we identified an unweighted sample of 4943 patients who underwent kidney cancer surgery in 2003. Main Outcome Measure: Our primary outcomes were patient receipt of (1) partial nephrectomy and/or (2) laparoscopic kidney cancer surgery. Results: Our weighted analytic cohort comprised 34,045 cases. Overall, 16% of patients received a partial nephrectomy, and 17% underwent laparoscopic surgery; at high-nephrectomy-volume hospitals the proportions increased to 22% and 26%, respectively. Hospital structural characteristics varied across nephrectomy-case volume strata. In unadjusted models, patients treated at hospitals in the highest-nephrectomy-volume tercile were more likely than those treated at low-volume facilities to receive a partial nephrectomy [Risk RatioPN (RRPN) 2.2; 95% confidence interval (CI), 1.6–2.8] or laparoscopic surgery (RRlap 2.9; 95% CI, 2.0–4.0). Adjusting for differences in hospital structure attenuated the association between hospital nephrectomy volume and use of partial nephrectomy or laparoscopy by 60% (adjusted RRPN 1.4; 95% CI, 0.9–2.2) and 12% (adjusted RRlap 2.5; 95% CI, 1.4–4.1), respectively. Conclusions: Changes to the hospital environment may facilitate greater use of partial nephrectomy at hospitals that infrequently perform kidney cancer surgery. Efforts to increase the uptake of laparoscopy are probably best directed at surgeon-specific adoption barriers.
Kidney cancer
Cite
Citations (29)
The prevalence of chronic kidney disease (CKD), especially the early stages, is still not exactly known. This is also true for CKD stage 3, when cardiovascular and other major complications generally appear. The NANHES data have shown a steady increase in the prevalence of CKD 3 up to 7.7% in 2004. Chronic kidney disease and renal failure are underdiagnosed all over the world. In Italy, prevalence estimates for stage 3 to 5 CKD are around 4 million yet, less than 30% of these subjects are believed to be followed at nephrology clinics. This means that in Italy for every dialyzed patient there are about 85 individuals with possibly progressive kidney disease, while fewer than five (mainly stage 4 and 5 patients) are actually followed by a nephrologist.
Nephrology
Chronic renal failure
Cite
Citations (179)
This chapter addresses the role of ancillary surgical procedures during kidney cancer surgery, namely the benefits and harms associated with lymphadenectomy and adrenalectomy. Curative treatment of renal cell carcinoma is primarily surgical via partial nephrectomy (removal of the tumor with preservation of the kidney) or total/radical nephrectomy (removal of the entire tumor-bearing kidney). The chapter also addresses a series of focused clinical questions that are addressed in a systematic fashion, including a comprehensive literature search, a rating of the quality of evidence, and an assessment of ratio of benefit and harm of a given treatment option. The clinical questions are: In patients with a renal tumor who are receiving nephrectomy, should retroperitoneal lymphadenectomy also be performed? and In patients with a renal tumor who are receiving nephrectomy, should ipsilateral adrenalectomy also be performed?
Kidney cancer
Lymphadenectomy
Cite
Citations (0)
You have accessJournal of UrologyKidney Cancer I: Partial Nephrectomy & Kidney Preservation Strategies (V01)1 Apr 2020Kidney Cancer I: Partial Nephrectomy & Kidney Preservation Strategies (V01) View All Author Informationhttps://doi.org/10.1097/JU.0000000000000826AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Expand All Advertisement PDF downloadLoading ...
Kidney cancer
Cite
Citations (0)
The National Kidney Foundation developed and oversees the Kidney Disease Outcomes Quality Initiative, a process that develops clinical practice guidelines in nephrology. Recent guidelines address the evaluation, classification, and stratification of chronic kidney disease (CKD). These guidelines provide, for the first time, a standard definition of CKD, classification of its stages, and suggestions for appropriate laboratory measurements for the assessment of kidney function. Also discussed are the association of level of kidney function with systemic complications that develop during CKD, and the risk of loss of kidney function and development of cardiovascular disease in CKD.
Nephrology
Risk Stratification
Clinical Practice
Cite
Citations (91)
Today radical nephrectomy (RN) is a gold standart of treatment localized kindney cancer (stage T1–2). The partial nephrectomy (PN) shows the same oncological outcomes as RN on this stage. However there are few artikles of efficiasy PN in kidney cancer more than 7 cm. The case report and review of literature is presented.
Kidney cancer
Cite
Citations (0)
Kidney cancer
Histopathology
Cite
Citations (12)
Abstract Chronic kidney disease (CKD) represents a public health burden worldwide and is associated with significant morbidity and mortality. Most patients with CKD are managed by primary care practitioners and this educational series hope to improve knowledge and delivery of care to this high-risk patient population with CKD.
Nephrology
Prime time
Cite
Citations (3)
Partial nephrectomy (PN) enables surgeons to obtain both radical resection of renal tumor and maximal preservation of normal kidney, which brings benefits on survival time and life quality for patients with early stage kidney cancer. Nevertheless, how to select the patients suitable for PN still remains a clinical challenge. In this article, by analyzing the domestic and overseas application status of PN, we summarized the advantages and disadvantages of PN for patients at different stages as well as difficulties and risks in PN on complicated renal tumor. The appropriate surgical indications could benefit more patients with kidney cancer through PN.
Key words:
Kidney neoplasms; Partial nephrectomy; Laparoscopy; Robot
Kidney cancer
Cite
Citations (0)
The prevalence of chronic kidney disease (CKD), especially the early stages, is still not exactly known. This is also true for CKD stage 3, when cardiovascular and other major complications generally appear. The NANHES data have shown a steady increase in the prevalence of CKD 3 up to 7.7% in 2004. Chronic kidney disease and renal failure are underdiagnosed all over the world. In Italy, prevalence estimates for stage 3 to 5 CKD are around 4 million yet, less than 30% of these subjects are believed to be followed at nephrology clinics. This means that in Italy for every dialyzed patient there are about 85 individuals with possibly progressive kidney disease, while fewer than five (mainly stage 4 and 5 patients) are actually followed by a nephrologist.
Nephrology
Chronic renal failure
Cite
Citations (4)