Risk factors of acute kidney injury after unilateral nephrectomy for chronic kidney dis-ease
Objective To analyze the occurrence of acute kidney injury(AKI)after unilateral nephrectomy in chronic kid-ney disease(CKD)patients,and to explore the risk factors of AKI after unilateral nephrectomy in CKD patients.Methods A total of 138 CKD patients(GFR<90 ml/min/1.73 m2)who underwent unilateral nephrectomy operation were reviewed from General Hos-pital of Central Theater Command and Hubei Provincial Corps Hospital of Chinese People's Armed Police Force from January 2010 to April 2024.The patients were divided into two groups according to whether AKI occurred within 7 days after operation.The pa-rameters:age,sex,smoking history,drinking history,hypertension history,diabetes history,blood creatinine,blood urea nitrogen,hemoglobin,healthy side renal glomerular filtration rate(GFR)(determination of renal dynamic imaging),preoperative total esti-mate glomerular filtration rate(eGFR)(calculation of MDRD formula),resection site of renal,and surgical method were collected and compared between the two groups.Logistic regression analysis was performed on the parameters with statistical significance(P<0.05)to screen out the risk factors of postoperative AKI.Results A total of 138 patients with CKD were enrolled with 95 patients developed AKI after surgery(68.8%incidence).Preoperative total eGFR(ml/min/1.73 m2):(75.0±17.0)in AKI group and(72.0±14.1)in non-AKI group,there was no significant difference between the two groups(P=0.310).Preoperative GFR(ml/min)of healthy kidney was 38.8±9.1 in AKI group and 52.6±12.0 in non-AKI group,with statistical significance(P=0.000).The total incidence of postoperative dialysis was 1.4%.There were significant differences in gender,smoking history,dia-betes history,hemoglobin and GFR parameters of healthy side kidney between the two groups(P<0.05).Multivariate Logistic re-gression analysis showed that male(P=0.003),low GFR of healthy side kidney(P=0.000),and history of diabetes(P=0.039)were the risk factors for postoperative AKI in CKD patients.Conclusions The risk of AKI after unilateral nephrectomy in CKD patients is very high.Male,low GFR of healthy side kidney,and history of diabetes are risk factors for AKI in CKD patients after uni-lateral nephrectomy operation.It is necessary to evaluate GFR of healthy side kidney by renal dynamic imaging before operation.
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