The Predictive Role of Nephrometry Scores in Evaluating The Effect of Partial Nephrectomy on Postoperative Kidney Functions in T1 Renal Cell Tumors

Abstract

Objective: We aimed at demonstrating the predictive role of different nephrometry scores in evaluating the effect of partial nephrectomy on postoperative kidney functions in patients with T1 kidney tumors. Materials and Methods: We included 44 patients with clinical stage T1 renal tumors who underwent laparoscopic partial nephrectomy between June 2018 and January 2020. Then, we performed abdominal cross-sectional imaging with computed tomography and magnetic resonance imaging. We recorded the warm ischemia time, operation time, and amount of intraoperative bleeding. The resulting changes were evaluated by determining preoperative, and third month postoperative creatinine and estimated glomerular filtration rates (eGFR). RENAL nephrometry, Preoperative Aspects and Dimensions Used for an Anatomic (PADUA) classificationand Diameter- Axial- Polar (DAP) scores were calculated for each patient. The relationship between a decline in renal function, duration of ischemia and RENAL/PADUA/DAP scores was equally explored to achieve the aim of the study. Results: The mean age of the patients at the time of surgery was 55.07±12.92 years, and the preoperative creatinine and eGFR values were 0.87 mg/dL and 93.17 mL/min, respectively. The third month postoperative creatinine and eGFRvalues were determined at 0.96 mg/dL and 86.52 mL/min, respectively. The mean RENAL (6.2±1.4), PADUA (6.8±1.0), and DAP (5.57±1.5) scores were also determined. Changes in creatinine and eGFR levels correlated significantly with RENAL/PADUA/ DAP scores and the ischemia time (p<0.05), but not with the operation time, the amount of bleeding, length of hospital stay, tumor size, and location (p>0.05). Conclusion: Changes in kidney functions and ischemia time correlates significantly withRENAL/PADUA/DAP nephrometry scores.