OBJECTIVE: To examine incidence of and risk factors for development of hyperlipidemia (HL) in patients undergoing radical nephrectomy (RN) or partial nephrectomy (PN) for renal cortical neoplasms, as HL is a major source of morbidity in chronic kidney disease (CKD).
PATIENTS AND METHODS: Two-center retrospective analysis of 905 patients (mean age 57.5 years, mean follow-up 78 months) who underwent RN (610) or PN (295) from 7/1987-6/2007. Demographics, preoperative and postoperative HL were recorded. De novo HL was defined ≥6 months after surgery with laboratory values meeting National Cholesterol Education Program ATP III definitions. Kaplan-Meier method was used to assess freedom from de novo HL. Multivariable analysis (MVA) was conducted to elucidate risk factors for de novo HL.
RESULTS: There were no significant differences with respect to demographics, preoperative GFR< 60 (p=0.123) and HL (p=0.144). Tumor size (cm) was significantly larger for RN (7.0 vs. PN 3.7, p< 0.001). Significantly greater postoperative GFR< 60 was noted in RN (45.7% vs. PN 18%, p< 0.001). Significantly more de novo HL developed in RN (23% vs. PN 6.4%, p< 0.001). Mean time to development of HL was longer for PN (54 vs. RN 44 months, p=0.03). Five-year freedom from de novo HL probability was 76% RN vs. 96% PN (p< 0.001). MVA demonstrated RN (OR 2.93, p=0.0107), preoperative (OR 1.98, p=0.037) and postoperative (OR 7.89, p< 0.001) GFR< 60 as factors associated with HL development.
CONCLUSION: Patients who underwent RN had significantly higher incidence and shorter time to development of de novo HL. RN, preoperative and postoperative eGFR< 60 were associated with development of HL. Further follow-up and prospective investigation is necessary to confirm these findings.
Written by:
Bagrodia A, Kopp RP, Mehrazin R, Lee HJ, Liss MA, Jabaji R, Kane CJ, Wake RW, Patterson AL, Wan JY, Derweesh IH. Are you the author?
Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Reference: BJU Int. 2014 Mar 24. Epub ahead of print.
doi: 10.1111/bju.12744
PubMed Abstract
PMID: 24656182
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