医学
肾功能
肾脏疾病
四分位间距
倾向得分匹配
置信区间
透析
外科
临床终点
肾切除术
急性肾损伤
回顾性队列研究
泌尿科
随机对照试验
肾
内科学
作者
Hao Kong,Yu-Xiu Zhang,Pengcheng Ye,Jia-Hui Ma,Jian Gao,Jie Guan
出处
期刊:Journal of Endourology
[Mary Ann Liebert]
日期:2021-12-16
标识
DOI:10.1089/end.2021.0620
摘要
Background: Previous randomized-controlled trials have demonstrated that intraoperative intravenous mannitol administration shows no added value on renal functional preservation after partial nephrectomy (PN) in patients with normal renal function. However, the renoprotective effect of mannitol has not been fully evaluated in patients with preoperative chronic kidney disease (CKD). Materials and Methods: This was a retrospective cohort study with propensity score matching. Patients with a preoperative estimated glomerular filtration rate (eGFR) of <60 mL/minute/1.73 m2 undergoing PN were enrolled in the study between January 2012 and December 2019 in Peking University First Hospital. Participants were divided into two groups: patients who received 25 g of mannitol (group M+) or not (group M-). The primary endpoint was the decreased rate of eGFR at the 6-month follow-up. Results: A total of 244 patients were included in the analysis. After propensity score matching, 80 patients remained in each group. The percentage of decrease from baseline eGFR at postoperative 6-month follow-up showed no difference between the two patient groups (median 11.1 [interquartile range 5.3-25.3] in group M+ vs 12.2 [4.7-21.3] in group M-, median difference -0.7 [95% confidence interval -4.6 to 3.1]; p = 0.704). Postoperative acute kidney injury, renal replacement therapy during hospitalization, postoperative complications, incidence of >20% decrease from baseline eGFR at 6 months, and dialysis at 6 months showed no difference between the two patient groups. Conclusions: A 25 g dose of mannitol administration during PN failed to provide added value on renal functional preservation in CKD patients.
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