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Abstract：
OBJECTIVE: The purpose of this study was to develop predictive models for postoperative estimated glomerular filtration rate (eGFR) based on the split glomerular filtration rate measured by radionuclide (rGFR), as choosing radical nephrectomy (RN) or partial nephrectomy (PN) for complex renal masses requires accurate prediction of postoperative eGFR.
METHODS: Patients who underwent RN or PN for a single renal mass at Xijing Hospital between 2008 and 2022 were retrospectively included. Preoperative split rGFR was evaluated using technetium-99 m-diethylenetriaminepentaacetic acid (Tc-99 m DTPA) renal dynamic imaging, and the postoperative short-term (< 7 days) and long-term (3 months to 5 years) eGFRs were assessed. Linear mixed-effect models were used to predict eGFRs, with marginal R2 reflecting predictive ability.
RESULTS: After excluding patients with missing follow-up eGFRs, the data of 2251 (RN: 1286, PN: 965) and 2447 (RN: 1417, PN: 1030) patients were respectively included in the long-term and short-term models. Two models were established to predict long-term eGFRs after RN (marginal R2 = 0.554) and PN (marginal R2 = 0.630), respectively. Two other models were established to predict short-term eGFRs after RN (marginal R2 = 0.692) and PN (marginal R2 = 0.656), respectively. In terms of long-term eGFRs, laparoscopic and robotic surgery were superior to open surgery in both PN and RN.
CONCLUSIONS: We developed novel tools for predicting short-term and long-term eGFRs after RN and PN based on split rGFR that can help in preoperative decision-making.
METHODS: Patients who underwent RN or PN for a single renal mass at Xijing Hospital between 2008 and 2022 were retrospectively included. Preoperative split rGFR was evaluated using technetium-99 m-diethylenetriaminepentaacetic acid (Tc-99 m DTPA) renal dynamic imaging, and the postoperative short-term (< 7 days) and long-term (3 months to 5 years) eGFRs were assessed. Linear mixed-effect models were used to predict eGFRs, with marginal R2 reflecting predictive ability.
RESULTS: After excluding patients with missing follow-up eGFRs, the data of 2251 (RN: 1286, PN: 965) and 2447 (RN: 1417, PN: 1030) patients were respectively included in the long-term and short-term models. Two models were established to predict long-term eGFRs after RN (marginal R2 = 0.554) and PN (marginal R2 = 0.630), respectively. Two other models were established to predict short-term eGFRs after RN (marginal R2 = 0.692) and PN (marginal R2 = 0.656), respectively. In terms of long-term eGFRs, laparoscopic and robotic surgery were superior to open surgery in both PN and RN.
CONCLUSIONS: We developed novel tools for predicting short-term and long-term eGFRs after RN and PN based on split rGFR that can help in preoperative decision-making.
摘要：
目的：本研究的目的是根据放射性核素（rGFR）测量的分裂肾小球滤过率，开发术后估计肾小球滤过率（eGFR）的预测模型，因为对于复杂的肾脏肿块选择根治性肾切除术(RN)或部分肾切除术(PN)需要准确预测术后eGFR。
方法：回顾性纳入2008年至2022年在西京医院因单个肾脏肿块而接受RN或PN的患者。术前使用99m-二亚乙基三胺五乙酸（Tc-99mDTPA）肾动态成像评估rGFR，评估术后短期(<7天)和长期(3个月至5年)eGFRs。线性混合效应模型用于预测eGFRs，边际R2反映了预测能力。
结果：排除缺少随访eGFR的患者后，将2251例(RN:1286,PN:965)和2447例(RN:1417,PN:1030)患者的数据分别纳入长期和短期模型.建立了两个模型来预测RN(边际R2=0.554)和PN(边际R2=0.630)后的长期eGFRs，分别。建立了另外两个模型来预测RN（边际R2=0.692）和PN（边际R2=0.656）后的短期eGFRs，分别。就长期eGFRs而言，在PN和RN中，腹腔镜和机器人手术均优于开放手术。
结论：我们开发了基于分裂rGFR预测RN和PN后短期和长期eGFR的新工具，可以帮助术前决策。
方法：回顾性纳入2008年至2022年在西京医院因单个肾脏肿块而接受RN或PN的患者。术前使用99m-二亚乙基三胺五乙酸（Tc-99mDTPA）肾动态成像评估rGFR，评估术后短期(<7天)和长期(3个月至5年)eGFRs。线性混合效应模型用于预测eGFRs，边际R2反映了预测能力。
结果：排除缺少随访eGFR的患者后，将2251例(RN:1286,PN:965)和2447例(RN:1417,PN:1030)患者的数据分别纳入长期和短期模型.建立了两个模型来预测RN(边际R2=0.554)和PN(边际R2=0.630)后的长期eGFRs，分别。建立了另外两个模型来预测RN（边际R2=0.692）和PN（边际R2=0.656）后的短期eGFRs，分别。就长期eGFRs而言，在PN和RN中，腹腔镜和机器人手术均优于开放手术。
结论：我们开发了基于分裂rGFR预测RN和PN后短期和长期eGFR的新工具，可以帮助术前决策。
