TY - JOUR
T1 - The effect of partial nephrectomy on blood pressure in patients with solitary kidney
AU - Gupta, Nikhil
AU - Ganesan, Vishnu
AU - Gao, Tian min
AU - Zabell, Joseph
AU - Campbell, Steven C.
AU - Haber, Georges Pascal
N1 - Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - Purpose: To determine the effect of partial nephrectomy (PN) in the solitary kidney on systolic and diastolic blood pressures (SBP and DBP, respectively), and use of antihypertensive medications. Methods: We performed a retrospective cohort study of solitary kidney patients who underwent PN for kidney cancer from 1999–2015. Primary outcomes evaluated were blood pressure (BP) and antihypertensive medication changes from baseline up to 5 years postoperatively. Using a multivariable mixed-effects model to account for repeated measurements, we evaluated the effect of PN on the outcome measurements while controlling for baseline patient, pathologic, and perioperative characteristics. Results: 292 patients who underwent PN on solitary kidneys met inclusion criteria (median [range] age, 63 [24–84] years; 179 men [61%]). SBP decreased immediately postoperatively (− 1.7 mmHg [− 2.6, − 0.7], p < 0.001), and further decreased by 0.04 mmHg per year (p = 0.01) postoperatively, for a total change of − 1.9 [− 3.9, 0.2] mmHg at 5 years (p = 0.01). DBP decreased immediately postoperatively (− 2.2 mmHg [− 2.7, − 1.7], p < 0.001), and then rebounded by 0.37 mmHg per year (p = 0.003) postoperatively, for a total change of − 0.4 [− 1.5, 0.7] mmHg at 5 years (p = 0.003). Antihypertensive medication use increased at 5 years (0.35 more medications per patient, p < 0.001). Conclusions: Our results suggest a minimal change in BP after PN, although patients increased antihypertensive medication use. This data suggests damage to renal parenchyma or hilar nerves during PN did not significantly impact BP regulation in our cohort.
AB - Purpose: To determine the effect of partial nephrectomy (PN) in the solitary kidney on systolic and diastolic blood pressures (SBP and DBP, respectively), and use of antihypertensive medications. Methods: We performed a retrospective cohort study of solitary kidney patients who underwent PN for kidney cancer from 1999–2015. Primary outcomes evaluated were blood pressure (BP) and antihypertensive medication changes from baseline up to 5 years postoperatively. Using a multivariable mixed-effects model to account for repeated measurements, we evaluated the effect of PN on the outcome measurements while controlling for baseline patient, pathologic, and perioperative characteristics. Results: 292 patients who underwent PN on solitary kidneys met inclusion criteria (median [range] age, 63 [24–84] years; 179 men [61%]). SBP decreased immediately postoperatively (− 1.7 mmHg [− 2.6, − 0.7], p < 0.001), and further decreased by 0.04 mmHg per year (p = 0.01) postoperatively, for a total change of − 1.9 [− 3.9, 0.2] mmHg at 5 years (p = 0.01). DBP decreased immediately postoperatively (− 2.2 mmHg [− 2.7, − 1.7], p < 0.001), and then rebounded by 0.37 mmHg per year (p = 0.003) postoperatively, for a total change of − 0.4 [− 1.5, 0.7] mmHg at 5 years (p = 0.003). Antihypertensive medication use increased at 5 years (0.35 more medications per patient, p < 0.001). Conclusions: Our results suggest a minimal change in BP after PN, although patients increased antihypertensive medication use. This data suggests damage to renal parenchyma or hilar nerves during PN did not significantly impact BP regulation in our cohort.
KW - Antihypertensive agents; carcinoma
KW - Blood pressure
KW - Nephrectomy
KW - Renal cell
KW - Solitary kidney
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U2 - 10.1007/s00345-020-03354-1
DO - 10.1007/s00345-020-03354-1
M3 - Article
C2 - 32728886
AN - SCOPUS:85088700221
JO - World Journal of Urology
JF - World Journal of Urology
SN - 0724-4983
ER -