Usefulness of a Pretreatment CT-Based Modified RENAL Nephrometry Score in Predicting Renal Function After Cryotherapy for T1a Renal Mass

Yoshiki Asayama, Akihiro Nishie, Yasuhiro Ushijima, Daisuke Okamoto, Koichiro Morita, Seiichiro Takao, Daisuke Kakihara, Keisuke Ishimatsu, Kousei Ishigami, Nobuhiro Fujita, Hiroshi Honda

Research output: Contribution to journalArticle

Abstract

Purpose: We investigated the usefulness of the modified RENAL nephrometry (mRN) scoring system for predicting post-cryotherapy renal function in patients with T1a renal mass. Patients and Methods: A total of 75 patients with a T1a renal mass were enrolled. The mRN score was determined based on the tumor size, the tumor’s exophytic/endophytic properties, the tumor’s nearness to the collecting system, and the anterior/posterior location of the kidney. The change in the estimated glomerular filtration rate (ΔeGFR) was calculated as follows: ΔeGFR = 100 × ([pretreatment eGFR − eGFR at 6 months after cryotherapy]/pretreatment eGFR). Based on the ΔeGFR results, we classified the patients into two groups: a preserved renal function group (ΔeGFR < 10%) and an impaired renal function group (ΔeGFR ≥ 10%). We then analyzed the relationships between the mRN score and ΔeGFR and between the mRN score and the chronic kidney disease (CKD) stage. Results: The mean ΔeGFR for all patients was 5.5%. The mRN scores of the preserved renal function group (5.8 ± 0.3) were significantly lower than those of the impaired group (7.4 ± 0.3) (p < 0.001). When the mRN score cutoff value was set at 7 points, the mRN had 67.7% sensitivity, 72.7% specificity, 61.8% positive predictive value (PPV), 76.1% negative predictive value (NPV), and 70.7% accuracy for predicting impaired renal function. For predicting a deterioration of CKD stage, the mRN had 92.9% sensitivity, 67.2% specificity, 39.4% PPV, 97.6% NPV, and 72% accuracy. Conclusion: Our newly proposed modified RENAL nephrometry score was suggested to be useful for predicting renal function after renal cryotherapy.

Original languageEnglish
Pages (from-to)1128-1134
Number of pages7
JournalCardioVascular and Interventional Radiology
Volume42
Issue number8
DOIs
Publication statusPublished - Aug 15 2019

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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