scholarly journals Prediction of significant estimated glomerular filtration rate decline after renal unit removal to aid in the clinical choice between radical and partial nephrectomy in patients with a renal mass and normal renal function

2019 ◽  
Vol 124 (6) ◽  
pp. 999-1005 ◽  
Author(s):  
Andrew G. McIntosh ◽  
Daniel C. Parker ◽  
Brian L. Egleston ◽  
Robert G. Uzzo ◽  
Mohammed Haseebuddin ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Partial Nephrectomy ◽  
Normal Renal Function ◽  
Renal Mass ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Renal Unit ◽  
Glomerular Filtration Rate Decline

Tumor Volume and Tumor Crossing of the Axial Renal Midline as Preoperative Predictors of Reduced Estimated Glomerular Filtration Rate After Robotic Partial Nephrectomy

2021 ◽  
Author(s):  
Haruyuki Ohsugi ◽  
Kyojiro Akiyama ◽  
Hisanori Taniguchi ◽  
Masaaki Yanishi ◽  
Motohiko Sugi ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Partial Nephrectomy ◽  
Filtration Rate ◽  
Tumor Volume ◽  
Estimated Glomerular Filtration Rate ◽  
Scoring Systems ◽  
Renal Tumors ◽  
Robotic Partial Nephrectomy

Abstract The ability of nephrometry scoring systems, including the radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines (R.E.N.A.L.), to predict loss of renal function after robotic partial nephrectomy (RPN) is still controversial. Therefore, we verified which combination of factors from nephrometry scoring systems, including tumor volume, was the most significant predictor of postoperative renal function. Patients who underwent RPN for cT1 renal tumors in our hospital were reviewed retrospectively (n=163). The preoperative clinical data (estimated glomerular filtration rate [eGFR], comorbidities, and nephrometry scoring systems including R.E.N.A.L.) and perioperative outcomes were evaluated. We also calculated the tumor volume using the equation applied to an ellipsoid by three-dimensional computed tomography. The primary outcome was reduced eGFR, which was defined as an eGFR reduction of ≥20% from baseline to 6 months after RPN. Multivariate logistic regression analyses were used to evaluate the relationships between preoperative variables and reduced eGFR. Of 163 patients, 24 (14.7%) had reduced eGFR. Multivariate analyses indicated that tumor volume (cutoff value≥14.11 cm3, indicating a sphere with a diameter≥approximately 3 cm) and tumor crossing of the axial renal midline were independent factors for reduced eGFR (odds ratio [OR], 4.57; P=0.003 and OR, 3.21; P=0.034, respectively). Our classification system using these two factors showed a higher area under the receiver operating characteristic curve (AUC) than previous nephrometry scoring systems (AUC=0.786 vs. 0.653–0.719), and it may provide preoperative information for counseling patients about renal function after RPN.

scholarly journals Initial Estimated Glomerular Filtration Rate Decline and Long-Term Renal Function During Intensive Antihypertensive Therapy

Hypertension ◽  
2020 ◽  
Vol 75 (5) ◽  
pp. 1205-1212 ◽  
Author(s):  
Didier Collard ◽  
Tom F. Brouwer ◽  
Rik H.G. Olde Engberink ◽  
Aeilko H. Zwinderman ◽  
Liffert Vogt ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Antihypertensive Therapy ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Glomerular Filtration Rate Decline

scholarly journals Effect of severe renal impairment on the pharmacokinetics of brigatinib

2021 ◽  
Author(s):  
Neeraj Gupta ◽  
Michael J. Hanley ◽  
David Kerstein ◽  
Meera Tugnait ◽  
Narayana Narasimhan ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Renal Impairment ◽  
Protein Binding ◽  
Healthy Volunteers ◽  
Glomerular Filtration ◽  
Normal Renal Function ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Severe Renal Impairment

SummaryBackground Brigatinib, a next-generation anaplastic lymphoma kinase (ALK) inhibitor, targets activated, mutant forms of ALK and overcomes mechanisms of resistance to the ALK inhibitors crizotinib, ceritinib, and alectinib. Brigatinib is approved in multiple countries for treatment of patients with ALK-positive non–small cell lung cancer. Based on population pharmacokinetic (PK) analyses, no dosage adjustment is required for patients with mild or moderate renal impairment. Methods An open-label, single-dose study was conducted to evaluate the PK of brigatinib (90 mg) in patients with severe renal impairment (estimated glomerular filtration rate < 30 mL/min/1.73 m2; n = 8) and matched healthy volunteers with normal renal function (estimated glomerular filtration rate ≥ 90 mL/min/1.73 m2; n = 8). Plasma and urine were collected for the determination of plasma protein binding and estimation of plasma and urine PK parameters. Results Plasma protein binding of brigatinib was similar between patients with severe renal impairment (92 % bound) and matched healthy volunteers with normal renal function (91 % bound). Unbound brigatinib exposure (area under the plasma concentration-time curve from time zero to infinity) was approximately 92 % higher in patients with severe renal impairment compared with healthy volunteers with normal renal function. The renal clearance of brigatinib in patients with severe renal impairment was approximately 20 % of that observed in volunteers with normal renal function. Conclusions These findings support a brigatinib dosage reduction of approximately 50 % in patients with severe renal impairment.Trial registry: Not applicable.

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