Volume 21 Issue 9
Sep.  2023
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Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(9): 1457-1460
WU Ying, ZHANG Yue, QIAN Weiwei, SUN Xin, MA Jiaxing, YU Dexin, ZHANG Tao. Risk factors analysis and clinical significance of acute kidney injury after laparoscopic nephron sparing surgery[J]. Chinese Journal of General Practice, 2023, 21(9): 1457-1460. doi: 10.16766/j.cnki.issn.1674-4152.003145
Citation: WU Ying, ZHANG Yue, QIAN Weiwei, SUN Xin, MA Jiaxing, YU Dexin, ZHANG Tao. Risk factors analysis and clinical significance of acute kidney injury after laparoscopic nephron sparing surgery[J]. Chinese Journal of General Practice, 2023, 21(9): 1457-1460. doi: 10.16766/j.cnki.issn.1674-4152.003145
shu

Risk factors analysis and clinical significance of acute kidney injury after laparoscopic nephron sparing surgery

doi: 10.16766/j.cnki.issn.1674-4152.003145

  • Department of Urology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China

Funds:

 2008085MH290

 2021xkjT036

 2021zhyx-C43

 2020LCYB20

 2021xkj036

  • Received Date: 2022-12-15
    Available Online: 2023-10-19
    Abstract
  •   Objective  To investigate the risk factors of postoperative acute kidney injury (AKI) after laparoscopic nephron sparing surgery (LNSS) in renal tumor patients.  Methods  Clinical data of 442 patients who received LNSS in Urology Department of the Second Affiliated Hospital of Anhui Medical University from January 2010 to September 2022 were retrospectively analyzed. The diagnosis of AKI according to the 2012 kidney disease improving global outcomes standard. Patients were divided into AKI group and non-AKI group according to whether they had postoperative AKI. Clinical parameters of the two groups were collected, including general data, preoperative blood and urine biomarker data, renal artery clamping time, maximum tumor diameter, pathology results, RENAL score, etc. The risk factors for AKI after LNSS were analyzed by univariate and multivariate logistic regression.  Results  There were 129 patients with postoperative AKI, with an incidence of 29.2% (129/442), including 115 patients (89.2%) with stage Ⅰ AKI, 12 patients (9.3%) with stage Ⅱ AKI and 2 patients (1.5%) with stage Ⅲ AKI. The univariate analysis showed that there were significant differences in body mass index (BMI, P=0.018), preoperative coronary heart disease (P=0.042), serum cystatin C (CysC) level (P=0.004), renal artery clamping time (P=0.006), surgery time (P < 0.001), maximum tumor diameter (P=0.003), and RENAL score (P < 0.001) between the two groups (all P < 0.05). Multivariate logistic regression analysis showed that preoperative coronary heart disease (P=0.042), high serum CysC level (P=0.013), long surgery time (P=0.004) and high RENAL score (P < 0.001) were independent risk factors for AKI after LNSS.  Conclusion  The risk factors of AKI after LNSS include BMI, preoperative coronary heart disease, serum CysC level, renal artery clamping time, surgery time, maximum tumor diameter, and RENAL score. For renal tumor patients with the above risk factors, special attention and coping strategies should be given before LNSS.

     

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