Serum and urinary biomarkers for predicting acute kidney injury after partial nephrectomy

The purpose of this study was to evaluate the ability of specific biomarkers to predict acute kidney injury (AKI) after partial nephrectomy.

A prospective study of 89 patients undergoing partial nephrectomy was conducted in the First Affiliated Hospital of Fujian Medical University. The patients were divided into two groups according to AKI status: an AKI group and non-AKI group. Receiver operator characteristic (ROC) curves were generated and the areas under the curve (AUCs) were compared.

Twenty-eight subjects (31.5%) developed AKI while sixty-one subjects (68.5%) did not. Vascular clamping time in the AKI group was longer than that in the non-AKI group (29 ± 17 min vs. 24 ± 9 min, P = 0.042). Eight patients (28.6%) received blood infusion in the AKI group compared with five patients (8.2%) in the non-AKI group (P = 0.021). The area under ROC curve for AKI prediction was 0.792 [95% confidence interval (CI) 0.697 to 0.888, P < 0.000] for serum cystatin C 24 hours after surgery and 0.756 (95% CI 0.656 to 0.857, P < 0.000) for serum cystatin C 48 hours after surgery. Multivariate regression analysis showed transfusion [Hazard ratio (HR) 3.712, P = 0.044] and 24 hours serum cystatin C (HR 41.594, P = 0.001) correlated with AKI.

Postoperative serum cystatin C may be an early predictor for AKI after partial nephrectomy. Transfusion may be an independent risk factor for AKI after partial nephrectomy.