Impact of Mayo Adhesive Probability score and BMI on renal functional decline after robotic assisted partial nephrectomy
Abstract Purpose The purpose of this study is to investigate the impact of Mayo Adhesive Probability (MAP) score and body mass index (BMI) on renal function decline after robotic assisted partial nephrectomy (RAPN). Methods We queried our prospective database for patients who underwent RAPN between...
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Wiley
2024-10-01
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| Series: | BJUI Compass |
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| Online Access: | https://doi.org/10.1002/bco2.417 |
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| author | Cesare Saitta Marco Paciotti Giovanni Lughezzani Giuseppe Garofano Margaret F. Meagher Kit L. Yuen Vittorio Fasulo Roberto Contieri Pier Paolo Avolio Andrea Piccolini Paola Arena Matilde Mantovani Edoardo Beatrici Marta Calatroni Francesco Reggiani Rodolfo F. Hurle Massimo Lazzeri Alberto Saita Paolo Casale Ithaar H. Derweesh Nicolò M. Buffi |
| author_facet | Cesare Saitta Marco Paciotti Giovanni Lughezzani Giuseppe Garofano Margaret F. Meagher Kit L. Yuen Vittorio Fasulo Roberto Contieri Pier Paolo Avolio Andrea Piccolini Paola Arena Matilde Mantovani Edoardo Beatrici Marta Calatroni Francesco Reggiani Rodolfo F. Hurle Massimo Lazzeri Alberto Saita Paolo Casale Ithaar H. Derweesh Nicolò M. Buffi |
| author_sort | Cesare Saitta |
| collection | DOAJ |
| description | Abstract Purpose The purpose of this study is to investigate the impact of Mayo Adhesive Probability (MAP) score and body mass index (BMI) on renal function decline after robotic assisted partial nephrectomy (RAPN). Methods We queried our prospective database for patients who underwent RAPN between January 2018 and December 2023. Outcomes were development of de novo CKD‐S3 (estimated glomerular filtration rate [eGFR] < 60 ml/min/1.73 m2). Multivariable analysis (MVA) via Cox regression identified predictors for CKD‐S3. Kaplan–Meier Analyses was fitted for survival assessment. Finally, multivariable linear regression was utilized to identify predictors of delta eGFR at last follow‐up (preoperative eGFR—last eGFR). Results Two‐hundred fifty‐eight patients were analysed (obese n = 49 [19%]; MAP score 0–2 = 135 [52.33%]; MAP score 3–5 = 123 [47.6%]) with a median follow‐up of 33 (IQR 20–42) months. MVA revealed, high MAP score (HR 2.29, p = 0.019), increasing RENAL score (HR 1.26, p = 0.009), increasing age (HR 1.04, p = 0.003), obesity (HR 2.38, p = 0.006) and diabetes mellitus (HR 2.38, p = 0.005) as associated with increased risk of development of CKD‐S3, while trifecta achievement was not (p = 0.63). Comparing low MAP score versus high MAP score 4‐year CKD‐S3 free survival was 87.8% versus 56.1% (p < 0.001). Multivariable linear regression showed that high MAP score (coefficient 6.64, p = 0.001) and BMI (coefficient 0.51, p = 0.011) were significantly associated with increased delta eGFR at last follow up. Conclusions MAP score and increasing BMI are predictor for long term renal functional detrimental. These insights may call consideration for closer follow‐up or greater medical scrutiny prior surgery in obese patients and with elevated MAP score. Further investigations are requisite. |
| format | Article |
| id | doaj-art-e3ec7ea1d77b4cddab3a8ac457718fba |
| institution | Kabale University |
| issn | 2688-4526 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wiley |
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| series | BJUI Compass |
| spelling | doaj-art-e3ec7ea1d77b4cddab3a8ac457718fba2024-12-24T02:30:44ZengWileyBJUI Compass2688-45262024-10-015101056106310.1002/bco2.417Impact of Mayo Adhesive Probability score and BMI on renal functional decline after robotic assisted partial nephrectomyCesare Saitta0Marco Paciotti1Giovanni Lughezzani2Giuseppe Garofano3Margaret F. Meagher4Kit L. Yuen5Vittorio Fasulo6Roberto Contieri7Pier Paolo Avolio8Andrea Piccolini9Paola Arena10Matilde Mantovani11Edoardo Beatrici12Marta Calatroni13Francesco Reggiani14Rodolfo F. Hurle15Massimo Lazzeri16Alberto Saita17Paolo Casale18Ithaar H. Derweesh19Nicolò M. Buffi20Department of Urology IRCCS Humanitas Research Hospital Rozzano ItalyDepartment of Urology IRCCS Humanitas Research Hospital Rozzano ItalyDepartment of Urology IRCCS Humanitas Research Hospital Rozzano ItalyDepartment of Urology IRCCS Humanitas Research Hospital Rozzano ItalyDepartment of Urology UC San Diego Health System La Jolla California USADepartment of Urology UC San Diego Health System La Jolla California USADepartment of Urology IRCCS Humanitas Research Hospital Rozzano ItalyDepartment of Urology IRCCS Humanitas Research Hospital Rozzano ItalyDepartment of Urology IRCCS Humanitas Research Hospital Rozzano ItalyDepartment of Urology IRCCS Humanitas Research Hospital Rozzano ItalyDepartment of Urology IRCCS Humanitas Research Hospital Rozzano ItalyBiomedical Science Humanitas University Pieve Emanuele ItalyDepartment of Urology IRCCS Humanitas Research Hospital Rozzano ItalyBiomedical Science Humanitas University Pieve Emanuele ItalyBiomedical Science Humanitas University Pieve Emanuele ItalyDepartment of Urology IRCCS Humanitas Research Hospital Rozzano ItalyDepartment of Urology IRCCS Humanitas Research Hospital Rozzano ItalyDepartment of Urology IRCCS Humanitas Research Hospital Rozzano ItalyDepartment of Urology IRCCS Humanitas Research Hospital Rozzano ItalyDepartment of Urology UC San Diego Health System La Jolla California USADepartment of Urology IRCCS Humanitas Research Hospital Rozzano ItalyAbstract Purpose The purpose of this study is to investigate the impact of Mayo Adhesive Probability (MAP) score and body mass index (BMI) on renal function decline after robotic assisted partial nephrectomy (RAPN). Methods We queried our prospective database for patients who underwent RAPN between January 2018 and December 2023. Outcomes were development of de novo CKD‐S3 (estimated glomerular filtration rate [eGFR] < 60 ml/min/1.73 m2). Multivariable analysis (MVA) via Cox regression identified predictors for CKD‐S3. Kaplan–Meier Analyses was fitted for survival assessment. Finally, multivariable linear regression was utilized to identify predictors of delta eGFR at last follow‐up (preoperative eGFR—last eGFR). Results Two‐hundred fifty‐eight patients were analysed (obese n = 49 [19%]; MAP score 0–2 = 135 [52.33%]; MAP score 3–5 = 123 [47.6%]) with a median follow‐up of 33 (IQR 20–42) months. MVA revealed, high MAP score (HR 2.29, p = 0.019), increasing RENAL score (HR 1.26, p = 0.009), increasing age (HR 1.04, p = 0.003), obesity (HR 2.38, p = 0.006) and diabetes mellitus (HR 2.38, p = 0.005) as associated with increased risk of development of CKD‐S3, while trifecta achievement was not (p = 0.63). Comparing low MAP score versus high MAP score 4‐year CKD‐S3 free survival was 87.8% versus 56.1% (p < 0.001). Multivariable linear regression showed that high MAP score (coefficient 6.64, p = 0.001) and BMI (coefficient 0.51, p = 0.011) were significantly associated with increased delta eGFR at last follow up. Conclusions MAP score and increasing BMI are predictor for long term renal functional detrimental. These insights may call consideration for closer follow‐up or greater medical scrutiny prior surgery in obese patients and with elevated MAP score. Further investigations are requisite.https://doi.org/10.1002/bco2.417BMICKD‐Sestimated glomerular filtration ratefunctional declineMAP scoreobesity |
| spellingShingle | Cesare Saitta Marco Paciotti Giovanni Lughezzani Giuseppe Garofano Margaret F. Meagher Kit L. Yuen Vittorio Fasulo Roberto Contieri Pier Paolo Avolio Andrea Piccolini Paola Arena Matilde Mantovani Edoardo Beatrici Marta Calatroni Francesco Reggiani Rodolfo F. Hurle Massimo Lazzeri Alberto Saita Paolo Casale Ithaar H. Derweesh Nicolò M. Buffi Impact of Mayo Adhesive Probability score and BMI on renal functional decline after robotic assisted partial nephrectomy BJUI Compass BMI CKD‐S estimated glomerular filtration rate functional decline MAP score obesity |
| title | Impact of Mayo Adhesive Probability score and BMI on renal functional decline after robotic assisted partial nephrectomy |
| title_full | Impact of Mayo Adhesive Probability score and BMI on renal functional decline after robotic assisted partial nephrectomy |
| title_fullStr | Impact of Mayo Adhesive Probability score and BMI on renal functional decline after robotic assisted partial nephrectomy |
| title_full_unstemmed | Impact of Mayo Adhesive Probability score and BMI on renal functional decline after robotic assisted partial nephrectomy |
| title_short | Impact of Mayo Adhesive Probability score and BMI on renal functional decline after robotic assisted partial nephrectomy |
| title_sort | impact of mayo adhesive probability score and bmi on renal functional decline after robotic assisted partial nephrectomy |
| topic | BMI CKD‐S estimated glomerular filtration rate functional decline MAP score obesity |
| url | https://doi.org/10.1002/bco2.417 |
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