Risk factors of hypertension after partial nephrectomy in patients with renal tumors

• Project/Area Number: 17K16782
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Urology
• Research Institution: National Cancer Center Japan
• Principal Investigator: Inoue Masaharu 国立研究開発法人国立がん研究センター, 東病院, 医員 (30727235)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥3,250,000 (Direct Cost: ¥2,500,000、Indirect Cost: ¥750,000); Fiscal Year 2018: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2017: ¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
• Keywords: 腎癌 / 高血圧 / 腎部分切除 / 泌尿器科学 / 腫瘍学

Outline of Final Research Achievements

Partial nephrectomy (PN) is now a standard surgical option for small renal tumors. However, PN theoretically has the potential to induce hypertension which could be reasons for cardiovascular events and worsened overall survival. In this study, we conducted a cross-sectional survey of home blood pressure and antihypertensive medications and evaluated the effect of PN on the progression of hypertension and its risk factors. Both systolic and diastolic blood pressure significantly increased after PN compared with radical nephrectomy (RN) and postoperative hypertension was more frequent after PN than after RN. In the patients who underwent PN, acute kidney injury and higher postoperative peak C-reactive protein were independent risk factors for postoperative hypertension. In conclusion, PN may cause postoperative progression of hypertension possibly through renal parenchymal damage.

Academic Significance and Societal Importance of the Research Achievements

本研究の成果により、腎部分切除後の高血圧の発症が予測される症例においては、早期に降圧薬を開始するなどの介入を行うことによって、生命予後の改善が期待できる可能性があるものと考える。また、腎部分切除後に高血圧を発症する可能性があることが広く認識されることにより、腎腫瘍に対するより適切な治療戦略を構築することが可能になることを期待している。

Research Products

• [Journal Article] Incidence and Risk Factors of Hypertension Following Partial Nephrectomy in Patients With Renal Tumors: A Cross-sectional Study of Postoperative Home Blood Pressure and Antihypertensive Medications. (2020)
  • Author(s): Fukushima H, Inoue M, Kijima T, Yoshida S, Yokoyama M, Ishioka J, Matsuoka Y, Saito K, Fujii Y.
  • Journal Title: Clinical Genitourinary Cancer Volume: - Issue: 5 Pages: e619-e628
  • DOI: 10.1016/j.clgc.2020.02.004
  • Peer Reviewed
• [Journal Article] Adherent Perinephric Fat in Asian Patients: Predictors and Impact on Perioperative Outcomes of Partial Nephrectomy. (2018)
  • Author(s): Kawamura N, Saito K, Inoue M, Ito M, Kijima T, Yoshida S, Yokoyama M, Ishioka J, Matsuoka Y, Kihara K, Fujii Y.
  • Journal Title: Urol Int. Volume: 101 Issue: 4 Pages: 437-442
  • DOI: 10.1159/000494068
  • Peer Reviewed
• [Journal Article] Preliminary Kidney Parenchymal Ligation Using Endoloop Ligatures-A Simple Method to Achieve a Trifecta in Laparoscopic Partial Nephrectomy Without Hilar Clamping for Polar Complex Tumors. (2018)
  • Author(s): Komai Y, Gotohda N, Matsubara N, Takeda H, Yuasa T, Inoue M, Yamamoto S, Yonese J.
  • Journal Title: Urology. Volume: 121 Pages: 182-188
  • DOI: 10.1016/j.urology.2018.08.023
  • Peer Reviewed
• [Presentation] 腎部分切除における腎実質縫合が周術期成績へ与える影響の検討 (2018)
  • Author(s): 井上雅晴、矢嶋習吾、増田 均
  • Organizer: 第32回日本泌尿器内視鏡学会総会
• [Presentation] Incidence and risk factors of postoperative hypertension after partial nephrectomy for renal tumors (2017)
  • Author(s): Inoue M, Fujii Y, Ito M, Kijima T, Yoshida S, Yokoyama M, Ishioka J, Matsuoka Y, Saito K, Kihara K.
  • Organizer: AUA Annual Meeting 2017
  • Int'l Joint Research
• [Presentation] 腎腫瘍に対する腎部分切除後の高血圧発症・増悪およびそのリスク因子 (2017)
  • Author(s): 井上 雅晴、藤井 靖久、伊藤 将也、木島 敏樹、吉田 宗一郎、横山 みなと、石岡 淳一郎、松岡 陽、齋藤 一隆、木原 和徳
  • Organizer: 第４８回腎癌研究会