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Risk of Postoperative Renal Failure in Radical Nephrectomy and Nephroureterectomy: A Validated Risk Prediction Model.
Ali A Nasrallah1, Charbel Gharios2, Mira Itani3
1Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon, aan28@mail.aub.edu.
Urologia Internationalis
|November 21, 2021
Summary
A new risk model predicts postoperative renal failure (PORF) after kidney surgery. This tool helps identify patients at high risk for better perioperative care.
Area of Science:
- Nephrology
- Urology
- Surgical Outcomes
Background:
- Postoperative renal failure (PORF) is a significant complication following radical nephrectomy and nephroureterectomy.
- PORF is associated with increased risk of chronic kidney disease and cardiovascular morbidity.
Purpose of the Study:
- To construct and validate a robust risk prediction model for PORF.
- To identify patients at high risk for PORF to optimize perioperative management.
Main Methods:
- Utilized the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2005-2017).
- Employed stepwise multivariate logistic regression for model derivation.
- Validated the model using an independent cohort from the ACS-NSQIP database.
Main Results:
- A 9-factor model was developed, including age, gender, diabetes, hypertension, BMI, preoperative creatinine, hematocrit, and platelet count.
- The model demonstrated strong predictive performance with a C-statistic of 0.79 in both derivation and validation cohorts.
- Excellent calibration was observed with an R2 of 0.99.
Conclusions:
- The developed risk prediction model is robust and validated for predicting PORF.
- This model can aid clinicians in identifying high-risk patients undergoing nephrectomy or nephroureterectomy.
- Optimization of perioperative care is crucial for patients identified as high risk for PORF.
Keywords:
Acute kidney injuryKidney neoplasmsLogistic modelsMinimally invasive surgical proceduresNephrectomyMore Related Videos
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