[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.

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.

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.