Risk Factors Analysis and Nomogram Model Construction for Acute Kidney Injury after Radical Nephrectomy
10.11969/j.issn.1673-548X.2024.11.027
- VernacularTitle:根治性肾切除术后急性肾损伤危险因素分析和列线图模型建立
- Author:
Sheng CHEN
1
;
Zesen YU
1
;
Tianyi YU
1
Author Information
1. 221000 徐州医科大学附属医院泌尿外科
- Publication Type:Journal Article
- Keywords:
Radical nephrectomy;
Acute kidney injury;
Nomogram;
Kidney cancer
- From:
Journal of Medical Research
2024;53(11):138-143,149
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors for acute kidney injury(AKI)after radical nephrectomy and construct a clini-cal prediction model.Methods The clinical data of 334 renal cancer patients who underwent radical nephrectomy from June 2020 to June 2023 in the Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed,and they were divided into AKI group(n=128)and non-AKI group(n=216)according to whether AKI occurred after operation.The clinical data of patients were collected,in-dependent predictors were screened,and the nomogram prediction model was established.Results Comparison of gender,diabetes melli-tus,glomerular filtration rate(GFR)of the healthy kidney,duration of surgery,hemoglobin to red cell distribution width ratio(HRR),platelet to lymphocyte ratio(PLR),albumin to globulin ratio(AGR),creatinine,urea nitrogen,and uric acid levels between AKI group and non-AKI group showed statistically significant differences(P＜0.05).Multivariate Logistic regression analysis showed that gender,diabetes mellitus,GFR of the healthy kidney,HRR,and urea nitrogen were independent risk factors for AKI after renal insufficiency.A nomogram prediction model was further constructed based on independent risk factors,and the area under the receiver operating character-istic(ROC)curve was 0.804.The calibration curve showed good agreement between the actual observation and the nomogram prediction,with an absolute error of 0.015;the Hosmer and Lemeshow test showedx2=10.997,P=0.202;and the decision analysis curve showed that the model's threshold probability of maximum net benefit was 8.0％-92.0％.Conclusion Gender,diabetes mellitus,GFR of the healthy kidney,HRR,and blood urea nitrogen are risk factors for acute kidney injury after radical nephrectomy.The column-line dia-gram model constructed on the basis of clinical factors can effectively predict the risk of developing acute kidney injury after radical ne-phrectomy,and can be applied to the clinic.
