Estimated glomerular filtration rate on postoperative day 7 predicts renal function preservation outcome after robot-assisted partial nephrectomy

Purpose To assess the predictive value of estimated glomerular filtration rate (eGFR) on postoperative day (POD) 7 in forecasting the post-operative renal function in patients who underwent robot-assisted partial nephrectomy (RAPN). Methods : We retrospectively examined data on RAPN performed from August 2016 to May 2022 at the University of Yamanashi hospital and assessed patient background, surgical outcome, and renal function. The eGFR preservation rate on POD7, and in 6 and 12 months were checked. The data were analyzed with Mann-Whitney U test and Fisher's exact test. Pearson’s product moment correlation coefficient was used to evaluate correlation between eGFR preservation rate within POD7 and in postoperative 12 months. Results : A total of 207 patients were included in this study. Median age was 66 and 141 male (68.1%) and 177 patients had cT1a tumor (85.5%) . The median tumor size was 25 mm. Trifecta was achieved in 162 cases (78.3%). In the group with less than 90% eGFR preservation at 12 months after surgery, both eGFR with postoperative 7 days and 6 months were significantly lower than the group with above 90%. Between these two groups, there was no significant difference in patient background and perioperative data. Logistic regression analysis also showed over 90% of eGFR preservation rate within POD7 was a factor associated with over 90% preserved at post-operative 12 months. Conclusion : Care should be taken to the patients with decreased eGFR at postoperative 7 days on RAPN to detect the post-operative renal function decrease and transfer to chronic renal failure treatment earlier.