The impact of warm ischemia time on short-term renal function after partial nephrectomy: a systematic review and meta-analysis
Abstract Purpose This study aimed to assess the impact of warm ischemia time on short-term renal function in individuals undergoing partial nephrectomy. Methods We conducted a comprehensive search for primary research articles from 1990 to October 15, 2024 across several databases, including MEDLINE...
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2025-05-01
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| Online Access: | https://doi.org/10.1186/s12894-025-01803-w |
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| author | Siyi Li Zhenlang Guo Yuan Li Franky Leung Chan Shusheng Wang Chiming Gu |
| author_facet | Siyi Li Zhenlang Guo Yuan Li Franky Leung Chan Shusheng Wang Chiming Gu |
| author_sort | Siyi Li |
| collection | DOAJ |
| description | Abstract Purpose This study aimed to assess the impact of warm ischemia time on short-term renal function in individuals undergoing partial nephrectomy. Methods We conducted a comprehensive search for primary research articles from 1990 to October 15, 2024 across several databases, including MEDLINE, Embase and the Cochrane Library. A random effects model was applied to determine multivariable adjusted odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Country and study design were utilised as outcome indicators in the regression model. Results Ten studies including 4,993 patients who underwent partial nephrectomy met the inclusion criteria. The threshold of potentially harmful ischemia time for renal artery occlusion ranges between 10 and 45 min. Our results revealed that long warm ischemia time was associated with decreased postoperative eGFR and poor short-term renal function (OR = 1.08; 95% CI = 1.02–1.15; P = 0.006) after partial nephrectomy. Sensitivity and meta-regression analyses demonstrated the robustness of the study’s findings. Conclusions Extended periods of warm ischemia, specifically exceeding 25–30 min, can inflict damage on kidneys undergoing surgical treatment. Minimising the duration of warm ischemia while simultaneously prioritising surgical safety and achieving clear margins is imperative. Moreover, ischemia time remains a modifiable risk factor and must be reduced to maintain overall short-term renal function. Relevant prospective and randomised controlled trials must be conducted to validate these findings. PROSPERO Registration number CRD42024560051. |
| format | Article |
| id | doaj-art-88a3de3f5c84498281ab8844313f74df |
| institution | DOAJ |
| issn | 1471-2490 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | BMC Urology |
| spelling | doaj-art-88a3de3f5c84498281ab8844313f74df2025-08-20T03:07:57ZengBMCBMC Urology1471-24902025-05-0125111110.1186/s12894-025-01803-wThe impact of warm ischemia time on short-term renal function after partial nephrectomy: a systematic review and meta-analysisSiyi Li0Zhenlang Guo1Yuan Li2Franky Leung Chan3Shusheng Wang4Chiming Gu5Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese MedicineDepartment of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese MedicineDepartment of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese MedicineSchool of Biomedical Sciences, The Chinese University of Hong KongDepartment of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese MedicineDepartment of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese MedicineAbstract Purpose This study aimed to assess the impact of warm ischemia time on short-term renal function in individuals undergoing partial nephrectomy. Methods We conducted a comprehensive search for primary research articles from 1990 to October 15, 2024 across several databases, including MEDLINE, Embase and the Cochrane Library. A random effects model was applied to determine multivariable adjusted odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Country and study design were utilised as outcome indicators in the regression model. Results Ten studies including 4,993 patients who underwent partial nephrectomy met the inclusion criteria. The threshold of potentially harmful ischemia time for renal artery occlusion ranges between 10 and 45 min. Our results revealed that long warm ischemia time was associated with decreased postoperative eGFR and poor short-term renal function (OR = 1.08; 95% CI = 1.02–1.15; P = 0.006) after partial nephrectomy. Sensitivity and meta-regression analyses demonstrated the robustness of the study’s findings. Conclusions Extended periods of warm ischemia, specifically exceeding 25–30 min, can inflict damage on kidneys undergoing surgical treatment. Minimising the duration of warm ischemia while simultaneously prioritising surgical safety and achieving clear margins is imperative. Moreover, ischemia time remains a modifiable risk factor and must be reduced to maintain overall short-term renal function. Relevant prospective and randomised controlled trials must be conducted to validate these findings. PROSPERO Registration number CRD42024560051.https://doi.org/10.1186/s12894-025-01803-wIschemiaPartial nephrectomyRenal functionSystematic reviewMeta-analysis |
| spellingShingle | Siyi Li Zhenlang Guo Yuan Li Franky Leung Chan Shusheng Wang Chiming Gu The impact of warm ischemia time on short-term renal function after partial nephrectomy: a systematic review and meta-analysis BMC Urology Ischemia Partial nephrectomy Renal function Systematic review Meta-analysis |
| title | The impact of warm ischemia time on short-term renal function after partial nephrectomy: a systematic review and meta-analysis |
| title_full | The impact of warm ischemia time on short-term renal function after partial nephrectomy: a systematic review and meta-analysis |
| title_fullStr | The impact of warm ischemia time on short-term renal function after partial nephrectomy: a systematic review and meta-analysis |
| title_full_unstemmed | The impact of warm ischemia time on short-term renal function after partial nephrectomy: a systematic review and meta-analysis |
| title_short | The impact of warm ischemia time on short-term renal function after partial nephrectomy: a systematic review and meta-analysis |
| title_sort | impact of warm ischemia time on short term renal function after partial nephrectomy a systematic review and meta analysis |
| topic | Ischemia Partial nephrectomy Renal function Systematic review Meta-analysis |
| url | https://doi.org/10.1186/s12894-025-01803-w |
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