From planning to prognosis: predicting renal function after minimally-invasive partial nephrectomy with artificial intelligence.

Abstract

This study presents a machine learning model to predict renal function decline following minimally-invasive partial nephrectomy. Using a dataset of 556 patients treated between 2015 and 2023, the model incorporated patient, tumor, and intraoperative surgical variables - including clamping strategy, resection technique, and renorrhaphy type - to estimate the 3-month postoperative eGFR drop. A Random Forest Regressor outperformed other models, achieving a prediction accuracy of 89.29%, a mean absolute error of 8.09 mL/min/1.73 m², and a strong correlation with observed outcomes (r=0.904, P<10^-42). These findings support the use of AI for personalized surgical planning and functional outcome prediction in nephron-sparing surgery.