Comparison of rates and risk factors for development of anaemia and erythropoiesis-stimulating agent utilization after radical or partial nephrectomy

Jeffrey Woldrich, Reza Mehrazin, Wassim M. Bazzi, Aditya Bagrodia, Ryan P. Kopp, John B. Malcolm, Christopher J. Kane, Anthony Patterson, Jim Wan, Ithaar H. Derweesh

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Abstract

Objective To examine the incidence of and risk factors for the development of anaemia and erythropoiesis-stimulation agent (ESA) treatment in patients undergoing radical nephrectomy (RN) and partial nephrectomy (PN) because anaemia is a significant cause of morbidity in chronic kidney disease. Patients and Methods The study comprised a retrospective review of 905 patients (610 RN/295 PN; mean age, 57.5 years; mean follow-up, 6.4 years) who underwent surgery for renal tumours at two institutions from July 1987 to June 2007. Demographics, disease characteristics and pre- and postoperative (i.e. renal function, metabolic parameters, anaemia and ESA treatment) were recorded. Data were analyzed within subgroups based on treatment (RN vs PN). Multivariate analysis was conducted to determine the risk factors for developing anaemia after surgery. Results Tumour size (cm) was significantly larger for RN (RN 7.0 vs PN 3.7; P < 0.001). No significant differences were noted with respect to demographics and preoperative anaemia (RN 16.4% vs PN 18.6%; P= 0.454) and ESA-treatment (RN 0.7% vs PN 1.4%; P= 0.499). After surgery, significantly less de novo anaemia (PN 4.1% vs RN 17.5%; P < 0.001) and ESA utilization (PN 2.7% vs RN 13.4%; P < 0.001) occurred in the PN cohort. Multivariate analysis showed that age ≤60 years (odds ratio, OR, 1.62; P= 0.008), African American ethnicity (OR, 2.30; P < 0.001), smoking (OR, 1.60; P= 0.013), glomerular filtration rate (GFR) <60 mL/min/1.73 m 2 (OR, 4.09; P < 0.001), ≤1+ proteinuria (OR, 2.19; P < 0.03), metabolic acidosis (OR, 4.08; P= 0.007) and RN (OR, 2.58; P < 0.001) were significantly associated with de novo anaemia. Conclusions Patients who underwent RN had a significantly higher prevalence of anaemia and ESA-treatment compared to a well-matched cohort that underwent PN. In addition to RN, age ≤60 years, African American ethnicity, history of smoking, GFR < 60 mL/min/1.73 m 2, proteinuria and metabolic acidosis were associated with developing anaemia.

Original languageEnglish (US)
Pages (from-to)1019-1025
Number of pages7
JournalBJU International
Volume109
Issue number7
DOIs
StatePublished - Apr 1 2012

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Hematinics
Nephrectomy
Anemia
Erythropoiesis
Acidosis
Glomerular Filtration Rate
Proteinuria
African Americans
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Comparison of rates and risk factors for development of anaemia and erythropoiesis-stimulating agent utilization after radical or partial nephrectomy. / Woldrich, Jeffrey; Mehrazin, Reza; Bazzi, Wassim M.; Bagrodia, Aditya; Kopp, Ryan P.; Malcolm, John B.; Kane, Christopher J.; Patterson, Anthony; Wan, Jim; Derweesh, Ithaar H.

In: BJU International, Vol. 109, No. 7, 01.04.2012, p. 1019-1025.

Research output: Contribution to journalReview article

Woldrich, Jeffrey ; Mehrazin, Reza ; Bazzi, Wassim M. ; Bagrodia, Aditya ; Kopp, Ryan P. ; Malcolm, John B. ; Kane, Christopher J. ; Patterson, Anthony ; Wan, Jim ; Derweesh, Ithaar H. / Comparison of rates and risk factors for development of anaemia and erythropoiesis-stimulating agent utilization after radical or partial nephrectomy. In: BJU International. 2012 ; Vol. 109, No. 7. pp. 1019-1025.
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title = "Comparison of rates and risk factors for development of anaemia and erythropoiesis-stimulating agent utilization after radical or partial nephrectomy",
abstract = "Objective To examine the incidence of and risk factors for the development of anaemia and erythropoiesis-stimulation agent (ESA) treatment in patients undergoing radical nephrectomy (RN) and partial nephrectomy (PN) because anaemia is a significant cause of morbidity in chronic kidney disease. Patients and Methods The study comprised a retrospective review of 905 patients (610 RN/295 PN; mean age, 57.5 years; mean follow-up, 6.4 years) who underwent surgery for renal tumours at two institutions from July 1987 to June 2007. Demographics, disease characteristics and pre- and postoperative (i.e. renal function, metabolic parameters, anaemia and ESA treatment) were recorded. Data were analyzed within subgroups based on treatment (RN vs PN). Multivariate analysis was conducted to determine the risk factors for developing anaemia after surgery. Results Tumour size (cm) was significantly larger for RN (RN 7.0 vs PN 3.7; P < 0.001). No significant differences were noted with respect to demographics and preoperative anaemia (RN 16.4{\%} vs PN 18.6{\%}; P= 0.454) and ESA-treatment (RN 0.7{\%} vs PN 1.4{\%}; P= 0.499). After surgery, significantly less de novo anaemia (PN 4.1{\%} vs RN 17.5{\%}; P < 0.001) and ESA utilization (PN 2.7{\%} vs RN 13.4{\%}; P < 0.001) occurred in the PN cohort. Multivariate analysis showed that age ≤60 years (odds ratio, OR, 1.62; P= 0.008), African American ethnicity (OR, 2.30; P < 0.001), smoking (OR, 1.60; P= 0.013), glomerular filtration rate (GFR) <60 mL/min/1.73 m 2 (OR, 4.09; P < 0.001), ≤1+ proteinuria (OR, 2.19; P < 0.03), metabolic acidosis (OR, 4.08; P= 0.007) and RN (OR, 2.58; P < 0.001) were significantly associated with de novo anaemia. Conclusions Patients who underwent RN had a significantly higher prevalence of anaemia and ESA-treatment compared to a well-matched cohort that underwent PN. In addition to RN, age ≤60 years, African American ethnicity, history of smoking, GFR < 60 mL/min/1.73 m 2, proteinuria and metabolic acidosis were associated with developing anaemia.",
author = "Jeffrey Woldrich and Reza Mehrazin and Bazzi, {Wassim M.} and Aditya Bagrodia and Kopp, {Ryan P.} and Malcolm, {John B.} and Kane, {Christopher J.} and Anthony Patterson and Jim Wan and Derweesh, {Ithaar H.}",
year = "2012",
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day = "1",
doi = "10.1111/j.1464-410X.2011.10432.x",
language = "English (US)",
volume = "109",
pages = "1019--1025",
journal = "BJU International",
issn = "1464-4096",
publisher = "Wiley-Blackwell",
number = "7",

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TY - JOUR

T1 - Comparison of rates and risk factors for development of anaemia and erythropoiesis-stimulating agent utilization after radical or partial nephrectomy

AU - Woldrich, Jeffrey

AU - Mehrazin, Reza

AU - Bazzi, Wassim M.

AU - Bagrodia, Aditya

AU - Kopp, Ryan P.

AU - Malcolm, John B.

AU - Kane, Christopher J.

AU - Patterson, Anthony

AU - Wan, Jim

AU - Derweesh, Ithaar H.

PY - 2012/4/1

Y1 - 2012/4/1

N2 - Objective To examine the incidence of and risk factors for the development of anaemia and erythropoiesis-stimulation agent (ESA) treatment in patients undergoing radical nephrectomy (RN) and partial nephrectomy (PN) because anaemia is a significant cause of morbidity in chronic kidney disease. Patients and Methods The study comprised a retrospective review of 905 patients (610 RN/295 PN; mean age, 57.5 years; mean follow-up, 6.4 years) who underwent surgery for renal tumours at two institutions from July 1987 to June 2007. Demographics, disease characteristics and pre- and postoperative (i.e. renal function, metabolic parameters, anaemia and ESA treatment) were recorded. Data were analyzed within subgroups based on treatment (RN vs PN). Multivariate analysis was conducted to determine the risk factors for developing anaemia after surgery. Results Tumour size (cm) was significantly larger for RN (RN 7.0 vs PN 3.7; P < 0.001). No significant differences were noted with respect to demographics and preoperative anaemia (RN 16.4% vs PN 18.6%; P= 0.454) and ESA-treatment (RN 0.7% vs PN 1.4%; P= 0.499). After surgery, significantly less de novo anaemia (PN 4.1% vs RN 17.5%; P < 0.001) and ESA utilization (PN 2.7% vs RN 13.4%; P < 0.001) occurred in the PN cohort. Multivariate analysis showed that age ≤60 years (odds ratio, OR, 1.62; P= 0.008), African American ethnicity (OR, 2.30; P < 0.001), smoking (OR, 1.60; P= 0.013), glomerular filtration rate (GFR) <60 mL/min/1.73 m 2 (OR, 4.09; P < 0.001), ≤1+ proteinuria (OR, 2.19; P < 0.03), metabolic acidosis (OR, 4.08; P= 0.007) and RN (OR, 2.58; P < 0.001) were significantly associated with de novo anaemia. Conclusions Patients who underwent RN had a significantly higher prevalence of anaemia and ESA-treatment compared to a well-matched cohort that underwent PN. In addition to RN, age ≤60 years, African American ethnicity, history of smoking, GFR < 60 mL/min/1.73 m 2, proteinuria and metabolic acidosis were associated with developing anaemia.

AB - Objective To examine the incidence of and risk factors for the development of anaemia and erythropoiesis-stimulation agent (ESA) treatment in patients undergoing radical nephrectomy (RN) and partial nephrectomy (PN) because anaemia is a significant cause of morbidity in chronic kidney disease. Patients and Methods The study comprised a retrospective review of 905 patients (610 RN/295 PN; mean age, 57.5 years; mean follow-up, 6.4 years) who underwent surgery for renal tumours at two institutions from July 1987 to June 2007. Demographics, disease characteristics and pre- and postoperative (i.e. renal function, metabolic parameters, anaemia and ESA treatment) were recorded. Data were analyzed within subgroups based on treatment (RN vs PN). Multivariate analysis was conducted to determine the risk factors for developing anaemia after surgery. Results Tumour size (cm) was significantly larger for RN (RN 7.0 vs PN 3.7; P < 0.001). No significant differences were noted with respect to demographics and preoperative anaemia (RN 16.4% vs PN 18.6%; P= 0.454) and ESA-treatment (RN 0.7% vs PN 1.4%; P= 0.499). After surgery, significantly less de novo anaemia (PN 4.1% vs RN 17.5%; P < 0.001) and ESA utilization (PN 2.7% vs RN 13.4%; P < 0.001) occurred in the PN cohort. Multivariate analysis showed that age ≤60 years (odds ratio, OR, 1.62; P= 0.008), African American ethnicity (OR, 2.30; P < 0.001), smoking (OR, 1.60; P= 0.013), glomerular filtration rate (GFR) <60 mL/min/1.73 m 2 (OR, 4.09; P < 0.001), ≤1+ proteinuria (OR, 2.19; P < 0.03), metabolic acidosis (OR, 4.08; P= 0.007) and RN (OR, 2.58; P < 0.001) were significantly associated with de novo anaemia. Conclusions Patients who underwent RN had a significantly higher prevalence of anaemia and ESA-treatment compared to a well-matched cohort that underwent PN. In addition to RN, age ≤60 years, African American ethnicity, history of smoking, GFR < 60 mL/min/1.73 m 2, proteinuria and metabolic acidosis were associated with developing anaemia.

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U2 - 10.1111/j.1464-410X.2011.10432.x

DO - 10.1111/j.1464-410X.2011.10432.x

M3 - Review article

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AN - SCOPUS:84858446795

VL - 109

SP - 1019

EP - 1025

JO - BJU International

JF - BJU International

SN - 1464-4096

IS - 7

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