{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T13:34:21Z","timestamp":1780925661095,"version":"3.54.1"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Urology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Radical nephrectomy is a recommended treatment for localized renal cell carcinoma when partial nephrectomy is not feasible. This approach is typically applied to patients with a normal contralateral kidney and no preexisting chronic kidney disease (CKD).<\/jats:p>\n                    <jats:p>The primary concern with surgery is its potential long-term impact on renal function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To assess the risk of development of chronic kidney disease after radical nephrectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and methods:<\/jats:title>\n                    <jats:p>This is a retrospective cohort study of patients with normal preoperative renal function and contralateral kidney who underwent radical nephrectomy for cancer. At the last follow-up, patients were categorized according to CKD-EPI guidelines as having normal renal function grades G1-2 or impaired renal function grade \u2a7eG3a. Univariable and multivariable Cox regression analyses were used to identify the significant risk factors for CKD-free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We included 135 patients, 49.1 SD 12.9\u2009years old, 62 women (45.9%), and 73 men (54.1%). Preoperative weight was 81 SD 18\u2009kg, and eGFR was 99.2 SD 19.2\u2009mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      . The last follow-up 32.8 SD 16.8\u2009months later showed that 38 (28.1%) patients developed renal impairment. Univariable analysis showed that preoperatively age in years, age \u2a7e65, male gender, hypertension, Charlson Comorbidity score, cerebrovascular disease, low preoperative eGFR, serum creatinine, and baseline CKD EPI grade G2 were significant predictors of last follow-up renal impairment. Intraoperatively, anesthesia duration, surgery duration, and postoperatively, within the first 48\u2009hours lower eGFR, creatinine, and CKD-EPI category G3-5 were significant risk factors predicting CKD. After exclusion of colinear risk factors, multivariable analysis, however, indicated that preoperative eGFR (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.027), lower intraoperative nadir MAP (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.006), and postoperative within 48-hour eGFR (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.003) were independent predictors of CKD-free survival at the last follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Significant risk factors for renal impairment after radical nephrectomy were a decreased preoperative eGFR, intraoperative hypotension and, within 48h, postoperative eGFR. No other preoperative or intraoperative risk factor independently predicted CKD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562872261429816","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T18:47:52Z","timestamp":1773254872000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["New-onset renal impairment following radical nephrectomy for renal cell carcinoma: a retrospective cohort study of clinical, intraoperative, and postoperative risk factors"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9908-9839","authenticated-orcid":false,"given":"Raouf M.","family":"Seyam","sequence":"first","affiliation":[{"name":"Department of Urology, King Faisal Specialist Hospital and Research Center, P.O. Box 3354, Riyadh, 11211, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alhasan M.","family":"Abduldaem","sequence":"additional","affiliation":[{"name":"Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar N.","family":"Alfehaid","sequence":"additional","affiliation":[{"name":"Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrhman M.","family":"Almaslamani","sequence":"additional","affiliation":[{"name":"Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatimah S.","family":"Alghsham","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noora M.","family":"Alassaf","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora M.","family":"Alghanam","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed G","family":"Sayed","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya I.","family":"Elnegali","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Norris","sequence":"additional","affiliation":[{"name":"Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia"},{"name":"Department of Anesthesia, King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan M.","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2022.03.006"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2016.11.038"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2009.09147.x"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-022-10245-8"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.2340\/sju.v59.40322"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.17002"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2014.04.016"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2009.08376.x"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2022.11.007"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8101530"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15531"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euros.2023.04.011"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(06)70803-8"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/21681805.2021.1948916"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2022.07.009"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2023.0543"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-024-15305-w"},{"key":"e_1_3_4_19_2","volume":"105","author":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","year":"2024","unstructured":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int 2024; 105: S117\u2013S314.","journal-title":"Kidney Int"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2102953"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2022.10.011"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/bju.13994"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.04.043"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2012.03.051"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-021-02976-2"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/jso.25037"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2009.05.090"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2020.588215"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/bju.14839"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/iju.12277"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-018-1901-2"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajprenal.00316.2022"}],"container-title":["Therapeutic Advances in Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562872261429816","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17562872261429816","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562872261429816","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T11:46:35Z","timestamp":1773402395000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17562872261429816"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":31,"alternative-id":["10.1177\/17562872261429816"],"URL":"https:\/\/doi.org\/10.1177\/17562872261429816","relation":{},"ISSN":["1756-2872","1756-2880"],"issn-type":[{"value":"1756-2872","type":"print"},{"value":"1756-2880","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"article-number":"17562872261429816"}}