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'Discontent is the first necessity of progress', Thomas A. Edison

机译：“不满是进步的第一要务”，托马斯·爱迪生

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This study from Kaag et al. [1] investigates predictors of renal functional decline after radical nephroureterectomy (RNU) in patients with upper tract urothelial carcinoma (UTUC). They evaluate early (2 months) and late (6 months) predictors of renal functional decline, finding that on a multivariable model only age at surgery and preoperative renal function were independently associated with early postoperative function. This is an intuitive finding whereby we expect older patients and those with lower renal function to have a more dramatic decrease in renal function after RNU. Age, preoperative renal function, and Charlson score were associated with late functional recovery. The latter is a counterintuitive finding, as higher Charlson score was associated with less decrease in renal function. Charlson comorbidity was not significant on univariate analyses. Why it would become significant on multivariate is unclear. Whether it is an artifact related to study methodology or is a real phenomenon will require further study.
机译：Kaag等人的这项研究。 [1]研究了上路尿路上皮癌（UTUC）患者行根治性肾切除术（RNU）后肾功能下降的预测因素。他们评估了肾功能下降的早期（2个月）和晚期（6个月）预测因素，发现在多变量模型中，只有手术年龄和术前肾功能与术后早期功能独立相关。这是一个直观的发现，据此，我们期望老年患者和肾功能较低的患者在RNU后肾功能的下降更为显着。年龄，术前肾功能和Charlson评分与晚期功能恢复有关。后者是违反直觉的发现，因为较高的Charlson评分与较少的肾功能下降相关。 Charlson合并症在单因素分析中不显着。为什么它会在多元变量上变得重要尚不清楚。无论是与研究方法有关的人工产物还是真实现象都需要进一步研究。

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