MP42-13 ASSOCIATION OF PARTIAL VERSUS RADICAL NEPHRECTOMY WITH SUBSEQUENT HYPERTENSION RISK FOLLOWING RENAL TUMOR RESECTION Article Swipe

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Paras Shah , Bradley C. Leibovich , Holly Van Houten , Timothy D. Lyon , Xiaoxi Yao , Paras Shah , Xiaoxi Yao , Meghan Knoedler , Lindsey R. Sangaralingham , Andrea G. Kattah , R. Houston Thompson , Nilay D. Shah , Stephen A. Boorjian ·

YOU? · · 2019 · Open Access · · DOI: https://doi.org/10.1097/01.ju.0000556216.81550.0b

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy III (MP42)1 Apr 2019MP42-13 ASSOCIATION OF PARTIAL VERSUS RADICAL NEPHRECTOMY WITH SUBSEQUENT HYPERTENSION RISK FOLLOWING RENAL TUMOR RESECTION Paras Shah*, Bradley Leibovich, Holly Van Houten, Timothy Lyon, Xiaoxi Yao, Paras Shah, Xiaoxi Yao, Meghan Knoedler, Lindsey Sangaralingham, Andrea Kattah, R. Houston Thompson, Nilay Shah, and Stephen Boorjian Paras Shah*Paras Shah* More articles by this author , Bradley LeibovichBradley Leibovich More articles by this author , Holly Van HoutenHolly Van Houten More articles by this author , Timothy LyonTimothy Lyon More articles by this author , Xiaoxi YaoXiaoxi Yao More articles by this author , Paras ShahParas Shah More articles by this author , Xiaoxi YaoXiaoxi Yao More articles by this author , Meghan KnoedlerMeghan Knoedler More articles by this author , Lindsey SangaralinghamLindsey Sangaralingham More articles by this author , Andrea KattahAndrea Kattah More articles by this author , R. Houston ThompsonR. Houston Thompson More articles by this author , Nilay ShahNilay Shah More articles by this author , and Stephen BoorjianStephen Boorjian More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556216.81550.0bAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Although partial nephrectomy (PN) represents the recommended management for small renal masses, recent series have suggested an increased risk of post-procedural hypertension relative to radical nephrectomy (RN). Our objective was to investigate the risks of new-onset and worsened hypertension after RN versus PN. METHODS: Using a national administrative database of privately insured and Medicare patients. a retrospective cohort study was performed of 9,207 patients and 4,686 patients who underwent RN and PN, respectively, for a renal mass between 01/01/2007 and 12/31/2016. One-to-one propensity-score matching was used to balance surgical groups based on patient demographics, baseline comorbidities, current medications, and surgery year. Primary outcomes included new-onset hypertension among patients with no history of hypertension, and worsened hypertension among patients with baseline hypertension. Subgroup analyses were conducted, stratified by age (≥75 versus <75 years) and presence of baseline kidney disease. Incidence rates and Cox proportional hazards models were used to compare outcomes in matched cohorts. RESULTS: Among 3,106 propensity-matched patients without preexisting hypertension, RN was associated with a higher risk for new-onset hypertension compared to PN (HR=1.40, 95%CI=1.22-1.60, P<0.001). Similarly, among 6,250 propensity-matched patients with hypertension prior to surgery, RN was associated with a higher risk for worsening of baseline hypertension (HR=1.18, 95%CI=1.10-1.26, P<0.001). Subgroup analyses were consistent with the main study findings for worsened hypertension (P for interaction ≥0.05). CONCLUSIONS: Radical nephrectomy was associated with higher risk for new-onset and worsened hypertension compared to PN, including among elderly patients and individuals with normal kidney function. Given prior noted associations between hypertension and non-cancer related morbidity, our results further encourage the preferential use of PN for management of localized renal masses when technically feasible. Source of Funding: None Floral Park, NY; Rochester, MN; Floral Park, NY; Rochester, MN© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e612-e612 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paras Shah* More articles by this author Bradley Leibovich More articles by this author Holly Van Houten More articles by this author Timothy Lyon More articles by this author Xiaoxi Yao More articles by this author Paras Shah More articles by this author Xiaoxi Yao More articles by this author Meghan Knoedler More articles by this author Lindsey Sangaralingham More articles by this author Andrea Kattah More articles by this author R. Houston Thompson More articles by this author Nilay Shah More articles by this author Stephen Boorjian More articles by this author Expand All Advertisement PDF downloadLoading ...

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Medicine Nephrectomy Resection Urology Renal tumor Internal medicine Surgery Kidney

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Type: article
Language: en
Landing Page: https://doi.org/10.1097/01.ju.0000556216.81550.0b
PDF: https://www.auajournals.org/doi/pdf/10.1097/01.JU.0000556216.81550.0b
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Cited By: 1
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DOI: https://doi.org/10.1097/01.ju.0000556216.81550.0b

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Title: MP42-13 ASSOCIATION OF PARTIAL VERSUS RADICAL NEPHRECTOMY WITH SUBSEQUENT HYPERTENSION RISK FOLLOWING RENAL TUMOR RESECTION

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Language: en

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Publication year: 2019

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Publication date: 2019-04-01

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Authors: Paras Shah, Bradley C. Leibovich, Holly Van Houten, Timothy D. Lyon, Xiaoxi Yao, Paras Shah, Xiaoxi Yao, Meghan Knoedler, Lindsey R. Sangaralingham, Andrea G. Kattah, R. Houston Thompson, Nilay D. Shah, Stephen A. Boorjian

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Concepts: Medicine, Nephrectomy, Resection, Urology, Renal tumor, Internal medicine, Surgery, Kidney

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Cited by: 1

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