Introduction Recent studies have proposed that nearby fat deposits may have metabolic influence on kidney cancer pathobiology. Both fat quantity and quality may play unique roles in this complex relationship. As such, we investigated whether perinephric fat surface area (PFA), a quantitative measure of fat, or Mayo Adhesive Probability (MAP) score, a qualitative measure, were predictive of malignant pathology or Fuhrman grade in small renal masses. Methods A total of 317 patients undergoing minimally invasive partial nephrectomy between 2010 and 2016 for renal masses were retrospectively reviewed. Preoperative abdominal CT and MRI scans were measured for PFA and MAP scores. Multiple binary logistic regression models were created to identify predictive factors of malignant disease and Fuhrman grade. Results A total of 253 patients had malignant masses, while 64 had benign masses. A total of 189 of the malignant masses were T1a, while 64 were designated T1b. A total of 221 patients with malignant masses had reported Fuhrman grades. Of these 211 patients, 143 (64.7%) had low-grade and 78 (35.3%) had high-grade disease. Mean PFA was 18.0 ± 13.3 cm2, while mean MAP score was 2.6 ± 1.2. Binary logistic regression analysis yielded three variables in the best-fit model for predictors of malignant pathology: MAP score (OR = 1.374, 95% CI: 1.007–1.873, P = 0.045), male sex (OR = 2.058, 95% CI: 1.004–4.218, P = 0.049), and BMI (OR = 1.064, 95% CI: 0.998–1.135, P = 0.059). Neither MAP nor PFA was predictive of Fuhrman grade. Conclusions MAP score, a measure of perinephric fat quality, but not PFA, a qualitative measure of fat quantity, was predictive of malignant pathology, raising the question whether fat quality rather than quantity may be involved in the pathophysiology of RCC in a large and diverse patient population. Understanding the increasing burden of obesity, further studies are needed to elaborate on these findings and to discern the exact relationship between perinephric fat deposits and renal tumorigenesis.

A comparison of perinephric fat surface area and Mayo Adhesive Probability score in predicting malignancy in T1 renal masses.

Simple Summary This systematic review explores the relationship between obesity and renal-cell carcinoma (RCC), focusing on how different types of fat measurements influence the behavior and prognosis of the disease. Despite some studies suggesting a protective role of certain fat deposits, particularly visceral adipose tissue (VAT), conflicting findings exist across different adipose metrics and RCC subtypes. Methodological variations and limitations, such as retrospective designs and sample size constraints, pose challenges to standardization and generalizability. Further research efforts are needed to understand these associations better and establish standardized approaches for adiposity assessment in RCC patients, which could inform clinical practice and therapeutic decision-making. Abstract (1) Background: Renal-cell carcinoma (RCC) incidence has been steadily rising, with obesity identified as a potential risk factor. However, the relationship between obesity and RCC prognosis remains unclear. This systematic review aims to investigate the impact of different adipose tissue measurements on RCC behavior and prognosis. (2) Methods: A search of MEDLINE databases identified 20 eligible studies focusing on various fat measurements, including visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), perirenal adipose tissue (PRAT), and the Mayo adhesive probability (MAP) score. (3) Results: The review revealed conflicting findings regarding the association between adipose tissue measurements and RCC outcomes. While some studies suggested a protective role of certain fat deposits, particularly VAT, against disease progression and mortality, others reported contradictory results across different adipose metrics and RCC subtypes. (4) Conclusions: Methodological variations and limitations, such as retrospective designs and sample size constraints, pose challenges to standardization and generalizability. Further research is needed to understand these associations better and establish standardized approaches for adiposity assessment in RCC patients, which could inform clinical practice and therapeutic decision-making.

A Review of the Paradigmatic Role of Adipose Tissue in Renal Cancer: Fat Measurement and Tumor Behavior Features

Many individuals consider nocturia a significant nuisance, leading to a reduced health-related quality of life (HRQOL). However, there has been a lack of psychometrically sound patient-reported outcome measures to assess the impact of nocturia on patients in Chinese contexts. This study aimed to translate, culturally adapt, and validate the International Consultation on Incontinence Questionnaire Nocturia Quality of Life Module (ICIQ-NQOL) for use among primary care patients in Hong Kong, China. Additionally, it sought to investigate the mechanisms that link nocturia and sleep quality with HRQOL by employing moderated mediation analysis. The traditional Chinese version of the ICIQ-NQOL was developed through iterative translations, cognitive debriefing interviews, and panel reviews. The psychometric evaluation included assessments of factor structure, convergent validity, concurrent validity, known-group validity, internal consistency, test-retest reliability and responsiveness. Study instruments included the ICIQ-NQOL, International Prostate Symptom Score (IPSS), Pittsburgh Sleep Quality Index (PSQI), and a modified Incontinence Impact Questionnaire-Short Form (IIQ-7). A total of 419 primary care patients were recruited from general outpatient clinics, among whom 228 experiencing an average of two or more nocturia episodes per night over the past four weeks. Confirmatory factor analysis supported the two-factor structure of the ICIQ-NQOL. Concurrent validity was confirmed by moderate correlations between the IIQ-7 total score and the total score as well as two domain scores of the ICIQ-NQOL (r ranging from 0.43 to 0.49, all p < 0.001). The ICIQ-NQOL also had moderate correlations with the IPSS total symptom score (r ranging from 0.40 to 0.48, all p < 0.001). Convergent validity was supported by moderate correlations between the global PSQI score and the total score as well as two domain scores of the ICIQ-NQOL (r ranging from 0.42 to 0.52, all p < 0.001). Known-group comparisons showed that the ICIQ-NQOL could differentiate between patients with and without nocturia in terms of sleep/energy domain score (p < 0.001), bother/concern domain score (p < 0.001), and total score (p < 0.001), each demonstrating a moderate Cohen’s d effect size. Item-total correlations corrected for overlap exceeded 0.4, and Cronbach’s alpha coefficients were greater than 0.7. Test-retest reliability was confirmed with intraclass correlation coefficients exceeding 0.7 among patients reporting no change in their nocturia symptoms at a 2-week follow-up. Regarding responsiveness, the Cohen’s d effect sizes for differences in domain and total scores between the baseline and 2-week follow-up assessments were greater than 0.3 among patients showing improvement in nocturia. Our moderated mediation analysis indicated that sleep quality significantly moderated the impact of nocturia on HRQOL, with a notably stronger indirect effect among females compared to males. The ICIQ-NQOL is a reliable and valid instrument for assessing the HRQOL in primary care patients suffering from nocturia. The findings advocate for gender-specific approaches in the management and treatment of nocturia to optimize HRQOL.

Psychometric properties and moderated mediation analysis of the ICIQ-NQOL in Chinese primary care patients with nocturia

Visceral adipose tissue and perirenal fat surface area as a predictor of renal cortical neoplasm histopathology

Objectives

To validate in Spanish (Spain) a self-administered questionnaire on the quality of life (QoL) specific to nocturia in an older adult male population.



Material and Methods

We analysed the Spanish version of the ICIQ-Nqol questionnaire (provided by ICIQ who owns the copyright), which meets the translation criteria required by the validation protocol. The study included 69 male patients older than 60 years of age with 1 or more nocturia episodes. The participants completed the questionnaire on two occasions, along with other Spanish-validated questionnaires that measure the QoL related to urinary symptoms. We analysed the internal reliability and consistency, reproducibility, convergent validity and discriminant validity.



Results

The study included 69 men, with a mean age of 70.64 years (range, 60-87 years). Both the overall scale and the energy/sleep subscale met the minimum criteria for internal reliability and consistency. A good correlation has been demonstrated between the overall index of the ICIQ-Nqol questionnaire and the other questionnaires included in the study. The reproducibility (test-retest reliability) of both the overall scale and subscales of the ICIQ-Nqol and the other questionnaires was demonstrated.



Conclusions The ICIQ-Nqol questionnaire has been shown to be an appropriate instrument for assessing the symptomatic intensity and impact on the QoL of patients with nocturia. This study confirms its validity for a Spanish-speaking male population. Neurourol. Urodynam. © 2015 Wiley Periodicals, Inc.

Spanish (Spain) validation of a specific symptomatic questionnaire for male patients with nocturia.

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Visceral adipose tissue and perirenal fat surface area as a predictor of renal cortical neoplasm histopathology

Spanish (Spain) validation of a specific symptomatic questionnaire for male patients with nocturia.