| dc.contributor.advisor | Leitsmann, Marianne PD Dr. | |
| dc.contributor.author | Hähner, Jan Michael | |
| dc.date.accessioned | 2025-07-14T17:19:56Z | |
| dc.date.available | 2025-09-10T00:50:06Z | |
| dc.date.issued | 2025-07-14 | |
| dc.identifier.uri | http://resolver.sub.uni-goettingen.de/purl?ediss-11858/16107 | |
| dc.identifier.uri | http://dx.doi.org/10.53846/goediss-11364 | |
| dc.format.extent | 65 | de |
| dc.language.iso | deu | de |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
| dc.subject.ddc | 610 | de |
| dc.title | Evaluation nicht-neoplastischer Veränderungen des Nierenparenchyms als Prädiktoren akuter Nierenschädigung nach Nephrektomie | de |
| dc.type | doctoralThesis | de |
| dc.contributor.referee | Leitsmann, Marianne PD Dr. | |
| dc.date.examination | 2025-08-13 | de |
| dc.description.abstracteng | Objective: The aim of this study was to evaluate non-neoplastic parenchymal changes in the
kidney as predictors of acute kidney injury (AKI) after radical
tumour nephrectomy.
Methods: Data from 135 patients with renal cell carcinoma
who underwent laparoscopic, open or Da Vinci
robot-assisted nephrectomy between 2013 and 2018 were retrospectively analysed. The histopathological findings of the
nephrectomy specimens were evaluated and divided into five groups. In addition,
pre- and postoperative renal function parameters were analysed with regard to the diagnosis
of AKI according to the KDIGO criteria. The non-neoplastic
parenchymal changes were analysed for a possible correlation with the occurrence of
postoperative AKI, as well as the occurrence of AKI in connection with
demographic, preoperative and intraoperative data.
Results: Overall, 44% (n=60) of patients developed AKI. Non-
neoplastic parenchymal changes were detected in 35.5 % (n=48) of the
nephrectomy specimens: Pyelonephritis in 17 % (n=23), glomerulosclerosis
in 14 % (n=19), other fibrotic changes in 4.4 % (n=6) and diabetic
nephropathies in 5 % (n=7). Nephrocalcinosis was not observed in any preparation
(n=0). Although none of the parenchymal changes analysed were associated with a significantly
increased risk of developing postoperative AKI
, 16.3% (n=22) of patients with AKI had one of the
parenchymal changes mentioned. An isolated analysis of patients with
higher-grade AKI revealed the presence of pyelonephritis in all patients with grade III AKI (n=3)
(100 %, p < 0.01).
Conclusion: The presented analysis of non-neoplastic
parenchymal changes in tumour nephrectomy specimens indicates that these
changes could play a central
role in estimating the risk of postoperative AKI. A significant correlation between the presence of pyelonephritis and the
occurrence of AKI was found in patients with severe AKI (grade III)
in particular. Even though no correlation could be shown outside this
subgroup, the findings provide valuable
insights into the relationships between pre- and postoperative factors and the
occurrence of acute renal failure. Future studies with larger, prospective
collectives could help to further validate the correlations shown here
and optimise diagnostic and therapeutic practice. In view of the
high incidence of postoperative AKI, such studies are essential in order to establish potential
diagnostic markers for the early identification of patients at risk in
everyday clinical practice and thus improve therapeutic approaches. | de |
| dc.contributor.coReferee | Wallbach, Manuel Prof. Dr. | |
| dc.contributor.thirdReferee | Bremmer, Felix Prof. Dr. | |
| dc.subject.eng | Acute kidney injury (AKI) | de |
| dc.subject.eng | Nephrectomy | de |
| dc.subject.eng | Non-neoplastic renal parenchymal changes | de |
| dc.subject.eng | Glomerulosclerosis | de |
| dc.subject.eng | Diabetic nephropathy | de |
| dc.subject.eng | Hypertensive nephropathy | de |
| dc.subject.eng | Histopathological evaluation | de |
| dc.subject.eng | Chronic kidney disease (CKD) | de |
| dc.subject.eng | Kidney function | de |
| dc.identifier.urn | urn:nbn:de:gbv:7-ediss-16107-2 | |
| dc.affiliation.institute | Medizinische Fakultät | de |
| dc.subject.gokfull | Urologie (PPN61987614X) | de |
| dc.subject.gokfull | Nephrologie (PPN619875828) | de |
| dc.subject.gokfull | Histopathologie {Medizin} (PPN619875704) | de |
| dc.description.embargoed | 2025-09-10 | de |
| dc.identifier.ppn | 1930551843 | |
| dc.notes.confirmationsent | Confirmation sent 2025-07-14T19:45:01 | de |