[Risk factors for perioperative acute kidney injury following partial nephrectomy in patients with stage 3 chronic kidney disease].

Q3 Medicine

北京大学学报（医学版） Pub Date : 2026-08-18

Ruotao Xiao, Zhifei Xie, Peng Hong, Bin Yang, Lei Liu, Shudong Zhang

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引用次数: 0

Abstract

Objective: To explore the risk factors for acute kidney injury (AKI) in patients with stage 3 chronic kidney disease (CKD) after partial nephrectomy.

Methods: The clinical data of 126 stage 3 CKD patients who underwent partial nephrectomy at Peking University Third Hospital from January 2013 to December 2025 were retrospectively analyzed. Demographic characteristics, comorbidities, surgical-related indicators, and laboratory data of the patients were collected. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Univariate and multivariate regression analyses were used to identify the independent risk factors for postoperative AKI, and the predictive cutoff value of the receiver operating characteristic (ROC) curve was determined.

Results: A total of 126 stage 3 CKD patients were included. The incidence of AKI after surgery was 31.0% (39/126). Univariate analysis showed that the proportion of robotic surgery was lower in the AKI group (12.8% vs. 33.3%, P=0.018), the duration of renal artery occlusion was longer (25 min vs. 18 min, P < 0.001), and the intraoperative blood loss was greater (20 mL vs. 50 mL, P=0.028). Multivariate Logistic regression analysis confirmed that the duration of renal artery occlusion (OR=1.105, 95%CI: 1.041-1.173, P=0.001) and intraoperative blood loss (OR=1.004, 95%CI: 1.000-1.007, P=0.046) were independent risk factors for postoperative AKI. ROC curve analysis showed that the area under the curve for predicting AKI by renal artery occlusion time was 0.737, and the optimal cutoff value was 18 min. The incidence of AKI was significantly higher in the patients with renal artery occlusion time ≥ 18 min than those with < 18 min (43.2% vs. 8.8%, P < 0.001).

Conclusion: The incidence of AKI after partial nephrectomy in stage 3 CKD patients is relatively high. The duration of renal artery occlusion and intra-operative blood loss are independent risk factors for postoperative AKI. Controlling the renal artery occlusion time within 18 min and minimizing intraoperative blood loss can help reduce the risk of AKI in this high-risk population after surgery.

本刊更多论文

[3期慢性肾病患者部分肾切除术后围手术期急性肾损伤的危险因素]。

目的：探讨3期慢性肾脏疾病（CKD）部分肾切除术后发生急性肾损伤（AKI）的危险因素。方法：回顾性分析2013年1月至2025年12月北京大学第三医院行部分肾切除术的126例3期CKD患者的临床资料。收集患者的人口学特征、合并症、手术相关指标和实验室数据。AKI是根据肾脏疾病：改善全球预后（KDIGO）标准定义的。采用单因素和多因素回归分析确定术后AKI的独立危险因素，确定受试者工作特征（ROC）曲线的预测截止值。结果：共纳入126例3期CKD患者。术后AKI发生率为31.0%（39/126）。单因素分析显示，AKI组机器人手术比例较低（12.8%比33.3%，P=0.018），肾动脉闭塞时间较长（25 min比18 min， P < 0.001），术中出血量较大（20 mL比50 mL， P=0.028）。多因素Logistic回归分析证实，肾动脉闭塞时间（OR=1.105, 95%CI: 1.041 ~ 1.173， P=0.001）和术中出血量（OR=1.004, 95%CI: 1.000 ~ 1.007， P=0.046）是术后AKI的独立危险因素。ROC曲线分析显示，肾动脉闭塞时间预测AKI的曲线下面积为0.737，最佳临界值为18 min。肾动脉闭塞时间≥18 min的患者AKI发生率明显高于< 18 min的患者（43.2% vs. 8.8%, P < 0.001）。结论：3期CKD患者部分肾切除术后AKI发生率较高。肾动脉闭塞时间和术中出血量是术后AKI的独立危险因素。将肾动脉闭塞时间控制在18 min以内，尽量减少术中出血量，有助于降低这一高危人群术后AKI的发生风险。

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来源期刊

北京大学学报（医学版） Medicine-Medicine (all)

CiteScore

0.80

自引率

0.00%

发文量

9815

期刊介绍： Beijing Da Xue Xue Bao Yi Xue Ban / Journal of Peking University (Health Sciences), established in 1959, is a national academic journal sponsored by Peking University, and its former name is Journal of Beijing Medical University. The coverage of the Journal includes basic medical sciences, clinical medicine, oral medicine, surgery, public health and epidemiology, pharmacology and pharmacy. Over the last few years, the Journal has published articles and reports covering major topics in the different special issues (e.g. research on disease genome, theory of drug withdrawal, mechanism and prevention of cardiovascular and cerebrovascular diseases, stomatology, orthopaedic, public health, urology and reproductive medicine). All the topics involve latest advances in medical sciences, hot topics in specific specialties, and prevention and treatment of major diseases. The Journal has been indexed and abstracted by PubMed Central (PMC), MEDLINE/PubMed, EBSCO, Embase, Scopus, Chemical Abstracts (CA), Western Pacific Region Index Medicus (WPR), JSTChina, and almost all the Chinese sciences and technical index systems, including Chinese Science and Technology Paper Citation Database (CSTPCD), Chinese Science Citation Database (CSCD), China BioMedical Bibliographic Database (CBM), CMCI, Chinese Biological Abstracts, China National Academic Magazine Data-Base (CNKI), Wanfang Data (ChinaInfo), etc.