Although commonly staged according to glomerular filtration rate (GFR), an international workgroup recommended classification of chronic kidney disease (CKD) by cause, GFR, and albuminuria. Data from non-surgical CKD patients indicate proteinuria to be an independent predictor of renal function decline and mortality.
We evaluated whether preoperative proteinuria impacts survival in patients undergoing nephrectomy.
An institutional registry was queried for information regarding preoperative creatinine/GFR and urinalysis obtained in 900 patients undergoing partial (n=362) or radical (n=538) nephrectomy. Patients were grouped according to GFR level (G1-G5), proteinuria level (A1-A3), and CKD risk classification (low-very high). Kaplan-Meier and Cox PH analyses of overall survival (OS) were performed.
Preoperative GFR was
Preoperative proteinuria is a significant predictor of OS in nephrectomy patients. Classification according to preoperative GFR and proteinuria more accurately predicts survival then using GFR alone after accounting for cancer stage. This information supports the routine evaluation of proteinuria in kidney cancer patients.
The Journal of urology. 2015 Sep 30 [Epub ahead of print]
Mouafak Tourojman, Samer Kirmiz, Bradley Boelkins, Sabrina L Noyes, Alan T Davis, Kelly O'Donnell, Conrad M Tobert, Brian R Lane
Spectrum Health Hospital System, Grand Rapids, MI. , Michigan State University College of Human Medicine, Grand Rapids, MI. , Michigan State University College of Human Medicine, Grand Rapids, MI. , Spectrum Health Hospital System, Grand Rapids, MI. , Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI; Grand Rapids Medical Education Partners, Grand Rapids, MI. , Michigan State University College of Human Medicine, Grand Rapids, MI. , Michigan State University College of Human Medicine, Grand Rapids, MI. , Spectrum Health Hospital System, Grand Rapids, MI; Michigan State University College of Human Medicine, Grand Rapids, MI.