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Validation of new baseline renal function predictive model in robotic-assisted partial nephrectomy cohort.
Geldmaker, Laura E; Baird, Bryce A; Gonzalez Albo, Giovanni A; Haehn, Daniela A; Ericson, Christian A; Wieczorek, Mikolaj A; Ball, Colleen T; Thiel, David D.
Afiliación
  • Geldmaker LE; Department of Urology, Mayo Clinic, Jacksonville, Florida, USA.
  • Baird BA; Department of Urology, Mayo Clinic, Jacksonville, Florida, USA.
  • Gonzalez Albo GA; Department of Urology, Mayo Clinic, Jacksonville, Florida, USA.
  • Haehn DA; Department of Urology, Mayo Clinic, Jacksonville, Florida, USA.
  • Ericson CA; Department of Urology, Mayo Clinic, Jacksonville, Florida, USA.
  • Wieczorek MA; Department of Clinical Trials and Biostatistics, Mayo Clinic, Jacksonville, Florida, USA.
  • Ball CT; Department of Clinical Trials and Biostatistics, Mayo Clinic, Jacksonville, Florida, USA.
  • Thiel DD; Department of Urology, Mayo Clinic, Jacksonville, Florida, USA.
Int J Urol ; 29(12): 1439-1444, 2022 12.
Article en En | MEDLINE | ID: mdl-36000924
OBJECTIVE: To validate a new baseline estimated glomerular filtration rate (NB-GFR) formula in a cohort of robotic-assisted partial nephrectomies (RAPN). METHODS: NB-GFR = 35 + preoperative GFR (× 0.65) - 18 (if radical nephrectomy) - age (× 0.25) + 3 (if tumor size >7 cm) - 2 (if diabetes). NB-GFR was calculated in 464 consecutive RAPN from a single surgeon cohort. 143 patients were excluded secondary to insufficient eGFR follow up. We analyzed NB-GFR accuracy utilizing the last observed eGFR 3-12 months post RAPN. Categorical variables were summarized with the frequency and percentage of patients. Numerical variables were summarized with the median, 25th percentile, and 75th percentile. RESULTS: The mean difference between observed and predicted NB-GFR was 4.6 ml/min/1.73m2 (95% CI -6.9 to 16.1 ml/min/1.73m2 ). There was a pattern of higher observed NB-GFRs being underestimated by the NB-GFR equation while lower observed NB-GFRs were overestimated by the NB-GFR equation. The NB-GFR formula had a high level of accuracy with 98.8% of predicted NB-GFRs falling within 30% of the observed NB-GFR (95% CI 86.8% to 99.5%). The median and interquartile range of the difference between observed and predicted NB-GFR was 3.9 ml/min/1.73m2 (IQR 0.7 to 8.2 ml/min/1.73m2 ). The sensitivity, specificity, positive predictive value, and negative predictive value for the ability of predicted NB-GFR to identify those with an observed NB-GFR <60 ml/min/1.73m2 after RAPN was 98%, 92%, 88%, and 99%, respectively. CONCLUSION: The NB-GFR equation developed with partial and radical nephrectomy cohorts is accurate in predicting post-operative eGFR 3-12 months following RAPN.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Robotizados / Neoplasias Renales Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Int J Urol Asunto de la revista: UROLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Australia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Robotizados / Neoplasias Renales Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Int J Urol Asunto de la revista: UROLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Australia