Body Composition May Be a Novel Presurgical Risk Factor for Acute Kidney Injury among Clear Cell Renal Cell Cancer...

Area of Science:

• Nephrology
• Urology
• Radiology

Background:

• Acute kidney injury (AKI) is a risk for patients with renal cell carcinoma (RCC) undergoing nephrectomy.
• Previous research focused on nonmodifiable risk factors for surgical AKI.
• Body composition is an understudied area for AKI risk stratification in RCC patients.

Purpose of the Study:

• To investigate the association between preoperative body composition features and AKI risk in RCC patients undergoing nephrectomy.
• To identify modifiable factors for presurgical risk stratification and potential interventions.

Main Methods:

• Analysis of 1199 patients with stages I-III clear cell RCC undergoing radical nephrectomy (RN) or partial nephrectomy (PN).
• AKI defined by serum creatinine increase within 48 hours or 7 days.
• Preoperative CT scans used to quantify adipose tissue and skeletal muscle; multivariable generalized linear models applied.

Main Results:

• AKI occurred more frequently in RN (66%) than PN (26%) patients.
• Higher visceral adipose tissue (VAT) quantity was significantly associated with increased AKI risk in RN patients (RD: 5.2 [95% CI: 1.3, 9.2]).
• The association between VAT and AKI was not significant in PN patients after multivariable adjustment.

Conclusions:

• Presurgical body composition and AKI risk associations differ based on nephrectomy type.
• Increased VAT quantity is a significant risk factor for AKI specifically in RN patients.
• CT-derived VAT quantity may serve as a novel imaging biomarker for AKI risk in RN patients, potentially guiding treatment selection or interventions.