Factors associated with acutely elevated serum creatinine following radical tumour nephrectomy: the Correlates of Kidney Dysfunction-Tumour Nephrectomy Database study.

Abstract

BACKGROUND:

To identify factors associated with acutely elevated serum creatinine (SCr) within 7 days of radical tumour nephrectomy.

METHODS:

The study population consisted of 130 consecutive patients managed for renal tumours. The primary outcome was acute kidney injury (AKI) (defined as SCr increase ≥50% above baseline), assessed using multivariable logistic regression analysis. The secondary outcome was SCr percentage increase, assessed using multivariable linear regression analysis.

RESULTS:

Following nephrectomy, the mean percentage increase in SCr in the first week was 55%±29%, and 77 (59%) patients experienced AKI. Independent predictors of AKI post-nephrectomy were male gender [adjusted odds ratio (OR): 2.67; 95% confidence interval (95% CI): 1.01, 6.93], urine albumin-creatinine ratio (OR: 0.66; 95% CI: 0.47, 0.91), preoperative estimated glomerular filtration rate (eGFR) (OR: 1.03; 95% CI: 1.00, 1.05), laparoscopic nephrectomy (OR: 3.02; 95% CI: 1.00, 9.12), and non-clear cell renal cell carcinoma (RCC) (OR: 2.93; 95% CI: 1.04, 8.29). Independent predictors of a SCr increase were male gender (β: 12.0; 95% CI: 2.69, 21.3), urine albumin-creatinine ratio (β: -3.36; 95% CI: -6.55, -0.16), preoperative eGFR (β: 0.38; 95% CI: 0.10, 0.66), laparoscopic nephrectomy (β: 12.7; 95% CI: 1.05, 24.3) and obesity (β: 9.94, 95% CI: 0.61, 19.3).

CONCLUSIONS:

Male gender, albuminuria, eGFR and laparoscopic nephrectomy independently associated with acutely elevated serum creatinine following radical tumour nephrectomy.

• Authors: Robert J Ellis, Sharon J Del Vecchio, Keng Lim Ng, Goce Dimeski, Elaine M Pascoe, Carmel M Hawley, David W Johnson, David A Vesey, Jeff S Coombes, Christudas Morais, Ross S Francis, Simon T Wood, Glenda C Gobe
• Journal: Translational andrology and urology (Transl Androl Urol) Vol. 6 Issue 5 Pg. 899-909 (Oct 2017) ISSN: 2223-4691 [Print] China
• PMID: 29184790 (Publication Type: Journal Article)