Objective To explore the correlation between the 5-factor modified frailty index(mFI-5)and acute kidney injury(AKI)after laparoscopic radical nephrectomy in elderly patients with renal cancer,so as to provide reference for the prevention and treatment of postoperative AKI.Methods A retrospective analysis was conducted on the clinical data of 214 elderly patients(≥60 years)who underwent laparoscopic radical nephrectomy at our hospital during Dec.2018 and Dec.2021.Patients were divided into frail group(n=75,mFI-5≥2)and non-frail group(n=139,mFI-5＜2).The incidence of AKI and sub items of mFI-5 were compared between the two groups.According to the occurrence of AKI,patients were divided into AKI group(n=77)and non-AKI group(n=137).Univariate and multivariate logistic analyses were conducted to identify risk factors of AKI.Receiver operating characteristic(ROC)curves were plotted to test the effectiveness of mFI-5 in predicting AKI.Results The incidence of AKI was significantly higher in the frail group than in the non-frail group(64.00％vs.20.86％,P＜0.05).Univariate analysis showed that the incidence of AKI was related to gender,diabetes,hypertension,nonfunctional independent status,weakness and split kidney glomerular filtration rate(GFR).Multivariate logistic regression analysis showed that male(OR=2.454,95％CI:1.193-5.047),complicated weakness(OR=6.580,95％CI:3.380-12.811),and low split kidney GFR(OR=0.945,95％CI:0.911-0.980)were independent risk factors of AKI(P＜0.05).The area under the ROC curve of AKI predicted by mFI-5 was 0.711.Conclusion Preoperative mFI-5 score is an effective predictor of AKI in elderly patients undergoing laparoscopic radical nephrectomy.As patients with frailty have a higher risk of AKI,preoperative evaluation and monitoring should be strengthened and timely intervention should be taken to improve the prognosis.
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