Table 9.
Nephron number of retained kidney as a predictor of progressive CKD among 1183 patients with kidney tumor with no cancer recurrence, death, or dialysis during the first 4 months post-nephrectomy surgery
| Predictor | Progressive CKD | Kidney Failure | ||
|---|---|---|---|---|
| HR (95% CI) | P Value | HR (95% CI) | P Value | |
| Unadjusted | ||||
| Nephron number, per 100,000 | 0.90 (0.85 to 0.95) | 0.0001 | 0.80 (0.71 to 0.90) | 0.0002 |
| Nephron number <5th percentile | 3.86 (2.52 to 5.90) | <0.0001 | 6.79 (3.27 to 14.12) | <0.0001 |
| Nephron number <10th percentile | 3.15 (2.10 to 4.74) | <0.0001 | 7.12 (3.47 to 14.60) | <0.0001 |
| % GSG, per SD | 1.59 (1.41 to 1.80) | <0.0001 | 1.80 (1.49 to 2.19) | <0.0001 |
| IFTA, per 5% | 1.20 (1.10 to 1.30) | <0.0001 | 1.25 (1.09 to 1.44) | 0.002 |
| IFTA foci density, per SD | 1.56 (1.34 to 1.80) | <0.0001 | 1.68 (1.28–2.21) | 0.0002 |
| Adjusted for nephrosclerosis measuresb | ||||
| Nephron number, per 100,000 | 0.95 (0.90–1.00) | 0.058 | 0.88 (0.77 to 1.00) | 0.048 |
| Nephron number <5th percentile | 2.51 (1.54–4.08) | 0.0002 | 3.83 (1.62 to 9.06) | 0.002 |
| Nephron number <10th percentile | 2.13 (1.34–3.38) | 0.001 | 4.54 (2.01 to 10.22) | 0.0003 |
| Further adjusted for glomerular volume | ||||
| Nephron number, per 100,000 | 0.99 (0.94–1.05) | 0.76 | 0.98 (0.87 to 1.11) | 0.77 |
| Nephron number <5th percentile | 1.73 (1.00–3.02) | 0.05 | 1.71 (0.62 to 4.73) | 0.30 |
| Nephron number <10th percentile | 1.45 (0.86–2.47) | 0.17 | 2.32 (0.90 to 5.96) | 0.08 |
| Further adjusted for clinical characteristicsc | ||||
| Nephron number, per 100,000 | 0.99 (0.92–1.06) | 0.74 | 1.04 (0.92 to 1.19) | 0.52 |
| Nephron number <5th percentile | 2.32 (1.27–4.26) | 0.006 | 1.44 (0.46 to 4.50) | 0.53 |
| Nephron number <10th percentile | 1.90 (1.08–3.34) | 0.026 | 2.12 (0.77 to 5.87) | 0.15 |
Progressive CKD was defined as eGFR reduction by 40% from post-nephrectomy baseline, dialysis, or kidney transplantation. Sample size was 1183 patients with 112 progressive CKD events, and 30 kidney failure events. HR, hazard ratio; 95% CI, 95% confidence interval; GSG, globally sclerosed glomeruli; IFTA, interstitial fibrosis/tubular atrophy.
b
%GSG, %IFTA and interstitial fibrosis and tubular atrophy foci density.
c
Age, sex, body mass index, hypertension, diabetes, post-surgery baseline eGFR, and proteinuria (continuous).