Intra-operative erythropoietin during laparoscopic partial nephrectomy is not renoprotective

Ephrem O. Olweny, Saad A. Mir, Samuel K. Park, Yung K. Tan, Stephen Faddegon, Sara L. Best, Cenk Gurbuz, Jeffrey A Cadeddu

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: In pre-clinical studies, acute erythropoietin (EPO) administration has been shown to mitigate the deleterious effects of ischemia/reperfusion injury. We reviewed our clinical experience with intraoperative EPO administration as a potential renoprotective agent during laparoscopic partial nephrectomy (LPN). Methods: Patients who underwent LPN at our institution between August 2008 and March 2010 received 500 IU/kg EPO 30 min prior to hilar occlusion. Those who underwent LPN between August 2006 and July 2008 without receiving EPO were selected as controls. Demographic, clinical, perioperative, and estimated glomerular filtration rate (eGFR) data were compared for the cohorts preoperatively, and during short-term (>6 months) and long-term (≥6 months) follow-up. Results: Short-term eGFR was evaluable for 39 EPO and 29 controls, while long-term eGFR was evaluable for 26 EPO and 27 controls. Baseline demographic and clinical features of the cohorts were similar. For EPO versus controls, median short and long-term follow-up was 19 days versus 22 days and 10.2 months versus 11.9 months, respectively. Mean preoperative, postoperative, and % change in eGFR were statistically similar for the cohorts during short- and long-term follow-up, without and with adjustment for baseline renal function (unadjusted P-values = 0.28, 0.095, and 0.38, respectively, short term, and 0.61, 0.50, and 0.69, respectively, long term). Conclusions: In this retrospective study, a single dose of EPO prior to hilar occlusion during LPN had no added protective impact on postoperative eGFR in the short or long term. Prospective evaluation in patients with solitary kidneys may better elucidate its potential renoprotective role in this setting.

Original languageEnglish (US)
Pages (from-to)519-524
Number of pages6
JournalWorld Journal of Urology
Volume30
Issue number4
DOIs
StatePublished - 2012

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Erythropoietin
Nephrectomy
Glomerular Filtration Rate
Demography
Kidney
Reperfusion Injury
Retrospective Studies

Keywords

  • Erythropoietin
  • Kidney
  • Minimally invasive
  • Recombinant
  • Surgical procedures
  • Warm ischemia

ASJC Scopus subject areas

  • Urology

Cite this

Intra-operative erythropoietin during laparoscopic partial nephrectomy is not renoprotective. / Olweny, Ephrem O.; Mir, Saad A.; Park, Samuel K.; Tan, Yung K.; Faddegon, Stephen; Best, Sara L.; Gurbuz, Cenk; Cadeddu, Jeffrey A.

In: World Journal of Urology, Vol. 30, No. 4, 2012, p. 519-524.

Research output: Contribution to journalArticle

Olweny, EO, Mir, SA, Park, SK, Tan, YK, Faddegon, S, Best, SL, Gurbuz, C & Cadeddu, JA 2012, 'Intra-operative erythropoietin during laparoscopic partial nephrectomy is not renoprotective', World Journal of Urology, vol. 30, no. 4, pp. 519-524. https://doi.org/10.1007/s00345-011-0760-6
Olweny, Ephrem O. ; Mir, Saad A. ; Park, Samuel K. ; Tan, Yung K. ; Faddegon, Stephen ; Best, Sara L. ; Gurbuz, Cenk ; Cadeddu, Jeffrey A. / Intra-operative erythropoietin during laparoscopic partial nephrectomy is not renoprotective. In: World Journal of Urology. 2012 ; Vol. 30, No. 4. pp. 519-524.
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abstract = "Purpose: In pre-clinical studies, acute erythropoietin (EPO) administration has been shown to mitigate the deleterious effects of ischemia/reperfusion injury. We reviewed our clinical experience with intraoperative EPO administration as a potential renoprotective agent during laparoscopic partial nephrectomy (LPN). Methods: Patients who underwent LPN at our institution between August 2008 and March 2010 received 500 IU/kg EPO 30 min prior to hilar occlusion. Those who underwent LPN between August 2006 and July 2008 without receiving EPO were selected as controls. Demographic, clinical, perioperative, and estimated glomerular filtration rate (eGFR) data were compared for the cohorts preoperatively, and during short-term (>6 months) and long-term (≥6 months) follow-up. Results: Short-term eGFR was evaluable for 39 EPO and 29 controls, while long-term eGFR was evaluable for 26 EPO and 27 controls. Baseline demographic and clinical features of the cohorts were similar. For EPO versus controls, median short and long-term follow-up was 19 days versus 22 days and 10.2 months versus 11.9 months, respectively. Mean preoperative, postoperative, and {\%} change in eGFR were statistically similar for the cohorts during short- and long-term follow-up, without and with adjustment for baseline renal function (unadjusted P-values = 0.28, 0.095, and 0.38, respectively, short term, and 0.61, 0.50, and 0.69, respectively, long term). Conclusions: In this retrospective study, a single dose of EPO prior to hilar occlusion during LPN had no added protective impact on postoperative eGFR in the short or long term. Prospective evaluation in patients with solitary kidneys may better elucidate its potential renoprotective role in this setting.",
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T1 - Intra-operative erythropoietin during laparoscopic partial nephrectomy is not renoprotective

AU - Olweny, Ephrem O.

AU - Mir, Saad A.

AU - Park, Samuel K.

AU - Tan, Yung K.

AU - Faddegon, Stephen

AU - Best, Sara L.

AU - Gurbuz, Cenk

AU - Cadeddu, Jeffrey A

PY - 2012

Y1 - 2012

N2 - Purpose: In pre-clinical studies, acute erythropoietin (EPO) administration has been shown to mitigate the deleterious effects of ischemia/reperfusion injury. We reviewed our clinical experience with intraoperative EPO administration as a potential renoprotective agent during laparoscopic partial nephrectomy (LPN). Methods: Patients who underwent LPN at our institution between August 2008 and March 2010 received 500 IU/kg EPO 30 min prior to hilar occlusion. Those who underwent LPN between August 2006 and July 2008 without receiving EPO were selected as controls. Demographic, clinical, perioperative, and estimated glomerular filtration rate (eGFR) data were compared for the cohorts preoperatively, and during short-term (>6 months) and long-term (≥6 months) follow-up. Results: Short-term eGFR was evaluable for 39 EPO and 29 controls, while long-term eGFR was evaluable for 26 EPO and 27 controls. Baseline demographic and clinical features of the cohorts were similar. For EPO versus controls, median short and long-term follow-up was 19 days versus 22 days and 10.2 months versus 11.9 months, respectively. Mean preoperative, postoperative, and % change in eGFR were statistically similar for the cohorts during short- and long-term follow-up, without and with adjustment for baseline renal function (unadjusted P-values = 0.28, 0.095, and 0.38, respectively, short term, and 0.61, 0.50, and 0.69, respectively, long term). Conclusions: In this retrospective study, a single dose of EPO prior to hilar occlusion during LPN had no added protective impact on postoperative eGFR in the short or long term. Prospective evaluation in patients with solitary kidneys may better elucidate its potential renoprotective role in this setting.

AB - Purpose: In pre-clinical studies, acute erythropoietin (EPO) administration has been shown to mitigate the deleterious effects of ischemia/reperfusion injury. We reviewed our clinical experience with intraoperative EPO administration as a potential renoprotective agent during laparoscopic partial nephrectomy (LPN). Methods: Patients who underwent LPN at our institution between August 2008 and March 2010 received 500 IU/kg EPO 30 min prior to hilar occlusion. Those who underwent LPN between August 2006 and July 2008 without receiving EPO were selected as controls. Demographic, clinical, perioperative, and estimated glomerular filtration rate (eGFR) data were compared for the cohorts preoperatively, and during short-term (>6 months) and long-term (≥6 months) follow-up. Results: Short-term eGFR was evaluable for 39 EPO and 29 controls, while long-term eGFR was evaluable for 26 EPO and 27 controls. Baseline demographic and clinical features of the cohorts were similar. For EPO versus controls, median short and long-term follow-up was 19 days versus 22 days and 10.2 months versus 11.9 months, respectively. Mean preoperative, postoperative, and % change in eGFR were statistically similar for the cohorts during short- and long-term follow-up, without and with adjustment for baseline renal function (unadjusted P-values = 0.28, 0.095, and 0.38, respectively, short term, and 0.61, 0.50, and 0.69, respectively, long term). Conclusions: In this retrospective study, a single dose of EPO prior to hilar occlusion during LPN had no added protective impact on postoperative eGFR in the short or long term. Prospective evaluation in patients with solitary kidneys may better elucidate its potential renoprotective role in this setting.

KW - Erythropoietin

KW - Kidney

KW - Minimally invasive

KW - Recombinant

KW - Surgical procedures

KW - Warm ischemia

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