ASO Author Reflections: Predicting New Baseline Renal Function After Partial Nephrectomy: The Importance of Accuracy, Conceptual Simplicity, and Clinical Practicality

Excerpt

Compared with radical nephrectomy, partial nephrectomy (PN) for localized renal cancer leads to greater renal functional preservation, which can be associated with improved survival.¹ Accurate prediction of new baseline glomerular filtration rate (NBGFR) after PN can thus inform clinical management when considering PN, and when counseling patients who require PN regarding their postoperative prognosis. The percentage of parenchymal volume preserved (PPVP) correlates with functional outcomes following PN, and several convoluted, labor-intensive methods for estimating PPVP exist.² However, simply presuming that ~ 11% of the GFR is lost from PN is equally accurate for estimating PPVP and NBGFR.² More recently, complex multivariable models based on patient/tumor/surgical parameters have been developed to predict NBGFR after PN.³ While these algorithms accurately predict NBGFR, their complex, multivariate nature limits their clinical utility. …