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Acute kidney injury after nephrectomy: a new nomogram to predict postoperative renal function
Lingyu Xu1, Chenyu Li1, Long Zhao1
1Department of Nephrology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China.
BMC Nephrology
|May 16, 2020
Summary
This study developed a nomogram to predict acute kidney injury (AKI) after nephrectomy, identifying key risk factors like radical nephrectomy and blood pressure. The tool aids early AKI detection and prognosis assessment.
Area of Science:
- Nephrology
- Urology
- Surgical Oncology
Background:
- Acute kidney injury (AKI) is a significant complication following nephrectomy.
- Predictive tools for AKI in this patient population are crucial for risk stratification and management.
- Early identification of patients at risk can improve outcomes and guide perioperative care.
Purpose of the Study:
- To develop and validate a nomogram for early prediction of postoperative AKI in patients undergoing radical or partial nephrectomy.
- To identify preprocedural predictors of AKI.
- To assess the long-term prognosis, including renal function and disease progression, in patients who develop AKI.
Main Methods:
- A development cohort (n=1111) and a validation cohort (n=356) were utilized.
- Stepwise and logistic regression analyses identified independent predictors of AKI.
- A nomogram was constructed using significant predictors and externally validated.
- Long-term follow-up assessed renal function, acute kidney disease (AKD), chronic kidney disease (CKD), readmission, and mortality.
Main Results:
- Independent risk factors for AKI included radical nephrectomy, aspirin use, systolic blood pressure, triglyceride levels, and alkaline phosphatase.
- Higher estimated glomerular filtration rate (eGFR) was associated with a lower risk of AKI.
- The nomogram demonstrated good predictive performance with an AUC of 0.77 in the development cohort and 0.72 in the validation cohort.
- Patients with AKI had significantly higher rates of AKD and CKD compared to those without AKI.
Conclusions:
- The developed nomogram exhibits excellent predictive ability for early AKI detection in nephrectomy patients.
- This tool has significant clinical implications for identifying at-risk individuals and guiding management strategies.
- The findings underscore the importance of monitoring renal function post-nephrectomy, especially in patients with identified risk factors.
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