Assessment of Warm and Cold Ischemia on Functions of the Operated Kidney with 99mTc-DMSA in Renal Masses: A Prospective and Randomized Study


Objective: To examine the effect of warm and cold ischemia on functions of the operated kidney in cases with a normal contralateral kidney undergoing nephron sparing surgery. Methods: This study enrolled 40 patients with a normal contralateral kidney and without a renal function threatening risk factor, who were operated with NSS. The patients were randomized at admission. They were divided into 2 equal groups as warm and cold ischemia. An ice application for 10 minutes was done to cold ischemia group after clamping renal artery. Renal functions were evaluated with Technesium-99m-Dimercaptosuccinic Acid (DMSA) and serum creatinine at the preoperative and postoperative (day 1, day 15, month 6, and month 12) period. Statistical analysis was done with Mann Whitney U test, Wilcoxon Signed Rank test, and Fredman test. A p value below 0.05 was considered statistically significant. Results: There were no significant differences between the groups in terms of age, body mass index, ischemia time, tumor size, amount of hemorrhage, and procedure time. Both groups had a significantly higher DMSA uptake at the preoperative period compared with the postoperative period (postoperative day 1, day 15, month 6, and month 12) (p < 0.001). However, both groups had similar DMSA uptake results at the postoperative period. Preoperative and postoperative creatinine levels were not significantly different from each other in both groups. Conclusion: Based on tumor localization, nephron sparing surgery without use of superficial cooling appears as a viable option for small renal masses.

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A. Demirtas, N. Baydilli, N. Sahin, O. Ekmekcioglu, D. Demirci and A. Tatlisen, "Assessment of Warm and Cold Ischemia on Functions of the Operated Kidney with 99mTc-DMSA in Renal Masses: A Prospective and Randomized Study," Open Journal of Urology, Vol. 3 No. 2, 2013, pp. 62-67. doi: 10.4236/oju.2013.32012.

Conflicts of Interest

The authors declare no conflicts of interest.


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