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Robust Association between Acute Kidney Injury after Radical Nephrectomy and Long-term Renal Function

The association between acute kidney injury (AKI) and long-term renal function after radical nephrectomy has not been evaluated fully. We reviewed 558 cases of radical nephrectomy. Postoperative AKI was defined by the Kidney Disease: Improving Global Outcomes (KDIGO) serum creatinine criteria. Value...

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Autores principales: Kim, Won Ho, Shin, Kyung Won, Ji, Sang-Hwan, Jang, Young-Eun, Lee, Ji-Hyun, Jeong, Chang Wook, Kwak, Cheol, Lim, Young-Jin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141119/
https://www.ncbi.nlm.nih.gov/pubmed/32106477
http://dx.doi.org/10.3390/jcm9030619
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author Kim, Won Ho
Shin, Kyung Won
Ji, Sang-Hwan
Jang, Young-Eun
Lee, Ji-Hyun
Jeong, Chang Wook
Kwak, Cheol
Lim, Young-Jin
author_facet Kim, Won Ho
Shin, Kyung Won
Ji, Sang-Hwan
Jang, Young-Eun
Lee, Ji-Hyun
Jeong, Chang Wook
Kwak, Cheol
Lim, Young-Jin
author_sort Kim, Won Ho
collection PubMed
description The association between acute kidney injury (AKI) and long-term renal function after radical nephrectomy has not been evaluated fully. We reviewed 558 cases of radical nephrectomy. Postoperative AKI was defined by the Kidney Disease: Improving Global Outcomes (KDIGO) serum creatinine criteria. Values of estimated glomerular filtration rate (eGFR) were collected up to 36 months (median 35 months) after surgery. The primary outcome was new-onset chronic kidney disease (CKD) stage 3a or higher or all-cause mortality within three years after nephrectomy. The functional change ratio (FCR) of eGFR was defined as the ratio of the most recent GFR (24–36 months after surgery) to the new baseline during 3–12 months. A multivariable Cox proportional hazard regression analysis for new-onset CKD and a multivariable linear regression analysis for FCR were performed to evaluate the association between AKI and long-term renal outcomes. A correlation analysis was performed with the serum creatinine ratio and used to determine AKI and FCR. AKI occurred in 43.2% (n = 241/558) and our primary outcome developed in 40.5% (n = 226/558) of patients. The incidence of new-onset CKD was significantly higher in patients with AKI than those without at all follow-up time points after surgery. The Cox regression analysis showed a graded association between AKI and our primary outcome (AKI stage 1: Hazard ratio 1.71, 95% confidence interval 1.25–2.32; AKI stage 2 or 3: Hazard ratio 2.72, 95% confidence interval 1.78–4.10). The linear regression analysis for FCR showed that AKI was significantly associated with FCR (β = −0.168 ± 0.322, p = 0.011). There was a significant negative correlation between the serum creatinine ratio and FCR. In conclusion, our analysis demonstrated a robust and graded association between AKI after radical nephrectomy and long-term renal functional deterioration.
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spelling pubmed-71411192020-04-10 Robust Association between Acute Kidney Injury after Radical Nephrectomy and Long-term Renal Function Kim, Won Ho Shin, Kyung Won Ji, Sang-Hwan Jang, Young-Eun Lee, Ji-Hyun Jeong, Chang Wook Kwak, Cheol Lim, Young-Jin J Clin Med Article The association between acute kidney injury (AKI) and long-term renal function after radical nephrectomy has not been evaluated fully. We reviewed 558 cases of radical nephrectomy. Postoperative AKI was defined by the Kidney Disease: Improving Global Outcomes (KDIGO) serum creatinine criteria. Values of estimated glomerular filtration rate (eGFR) were collected up to 36 months (median 35 months) after surgery. The primary outcome was new-onset chronic kidney disease (CKD) stage 3a or higher or all-cause mortality within three years after nephrectomy. The functional change ratio (FCR) of eGFR was defined as the ratio of the most recent GFR (24–36 months after surgery) to the new baseline during 3–12 months. A multivariable Cox proportional hazard regression analysis for new-onset CKD and a multivariable linear regression analysis for FCR were performed to evaluate the association between AKI and long-term renal outcomes. A correlation analysis was performed with the serum creatinine ratio and used to determine AKI and FCR. AKI occurred in 43.2% (n = 241/558) and our primary outcome developed in 40.5% (n = 226/558) of patients. The incidence of new-onset CKD was significantly higher in patients with AKI than those without at all follow-up time points after surgery. The Cox regression analysis showed a graded association between AKI and our primary outcome (AKI stage 1: Hazard ratio 1.71, 95% confidence interval 1.25–2.32; AKI stage 2 or 3: Hazard ratio 2.72, 95% confidence interval 1.78–4.10). The linear regression analysis for FCR showed that AKI was significantly associated with FCR (β = −0.168 ± 0.322, p = 0.011). There was a significant negative correlation between the serum creatinine ratio and FCR. In conclusion, our analysis demonstrated a robust and graded association between AKI after radical nephrectomy and long-term renal functional deterioration. MDPI 2020-02-25 /pmc/articles/PMC7141119/ /pubmed/32106477 http://dx.doi.org/10.3390/jcm9030619 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Won Ho
Shin, Kyung Won
Ji, Sang-Hwan
Jang, Young-Eun
Lee, Ji-Hyun
Jeong, Chang Wook
Kwak, Cheol
Lim, Young-Jin
Robust Association between Acute Kidney Injury after Radical Nephrectomy and Long-term Renal Function
title Robust Association between Acute Kidney Injury after Radical Nephrectomy and Long-term Renal Function
title_full Robust Association between Acute Kidney Injury after Radical Nephrectomy and Long-term Renal Function
title_fullStr Robust Association between Acute Kidney Injury after Radical Nephrectomy and Long-term Renal Function
title_full_unstemmed Robust Association between Acute Kidney Injury after Radical Nephrectomy and Long-term Renal Function
title_short Robust Association between Acute Kidney Injury after Radical Nephrectomy and Long-term Renal Function
title_sort robust association between acute kidney injury after radical nephrectomy and long-term renal function
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141119/
https://www.ncbi.nlm.nih.gov/pubmed/32106477
http://dx.doi.org/10.3390/jcm9030619
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