Impact of renal function on cardiovascular events in patients undergoing radical nephrectomy for renal cancer

Abstract

OBJECTIVE: To examine the actual impact of renal dysfunction on cardiovascular events in Japanese patients undergoing radical nephrectomy for renal cancer. METHODS: This retrospective study included 178 Japanese patients who underwent radical nephrectomy between 1980 and 2010. Kaplan-Meier survival curves with a log-rank test and the Cox proportional hazards model were used to investigate the impact of the estimated glomerular filtration rate at 1 month after the radical nephrectomy on cardiovascular-event-free, cancer-specific and overall survivals. RESULTS: During a median follow up of 68 months, 23 patients experienced cardiovascular events and 32 died. Postoperative renal dysfunction (estimated glomerular filtration rate <45 mL/min/1.73 m(2) 1 month after radical nephrectomy) was a significant risk factor for postoperative cardiovascular events in addition to age and history of cardiovascular disease. After adjustment for preoperative characteristics, postoperative renal dysfunction increased the risk of cardiovascular events by 3.48-fold (95% confidence interval 1.28-8.66). For overall and cancer-specific survivals, postoperative renal dysfunction did not represent an independent risk factor. CONCLUSION: Renal dysfunction has a significant impact on cardiovascular events in patients undergoing radical nephrectomy for renal cancer.