Abstract:

Ｏｂｊｅｃｔｉｖｅ：To study the change of renal function in renal cell carcinoma(RCC) patients who underwent radical nephrectomy,to explore the risk factors of acute kidney injury (AKI) after operation and chronic kidney disease (CKD) in longterm followeup.
Ｍｅｔｈｏｄｏｌｏｇｙ：data of 85 RCC patients having radical nephrectomy in Shanghai Ruijin North Hospital from Jan2013 to Jan2018 was collected and retrospectively studied.Incidence of AKI after operation was calculated and its risk factors were analyzed.KaplanMeier method was used to estimate the cumulative incidence of CKD during the followup.Univariate and multivariate analysis were performed to find out risk factors for CKD.
Ｒｅｓｕｌｔｓ：Eightyfive patients with a median followup of 18(726) months,were enrolled in this study.A rapid decline of eGFR was observed immediately after operation.Then eGFR gradually recoverd for the next 3 months and remained relatively stable during the followup.There were 47 cases (553%) of AKI,26 of which (553%) recovered before discharge.A low preoperative eGFR indicated a prolonged recovery (P=0028).Univariate analysis indicated that male gender,diabetes,hyperuricemia,contralateral kidney with lower eGFR and smaller tumor size were associated with AKI.Logistics regression analysis showed that contralateral kidney with lower eGFR (OR=0892,P=0018) and diabetes (OR=7856,P=0038) were independent risk factors for AKI.36 out of 78 patients with normal preoperative renal function progressed to CKD during the followup.The 1,3 and 5 year cumulative incidence of CKD estimated by KaplanMeier method was 389%,508% and 570%,respectively.There were significant differences in age,eGFR of the contralateral kidney,preand postoperative eGFR between the CKD and nonCKD groups.Logistics regression analysis showed that lower preoperative eGFR (OR=0794,P=0005) was an independent risk factor for CKD.
Ｃｏｎｃｌｕｓｉｏｎ：patients with RCC have a high incidence of AKI and CKD after radical nephrectomy.Contralateral kidney with lower eGFR and diabetes were associated with AKI,while lower preoperative eGFR was associated with CKD in the long term.

Key words: acute kidney injury, chronic kidney disease, renal cell carcinoma, radical nephrectomy