Perioperative Anaemia is a Risk Factor of Acute Kidney Injury in Patients Undergoing Partial Nephrectomy

Abstract

Background Acute kidney injury (AKI) secondary to partial nephrectomy (PN) is a challenging clinical issue. During PN anaemia develops due to haemodilution and blood loss, which decreases oxygen transfer and provokes tissue hypoxia, leading to postoperative adverse outcomes. The aim of this study was to investigate the impact of perioperative anaemia on postoperative AKI after PN.Methods This retrospective cohort study included 68 adult patients undergoing PN for a single nonmetastatic renal tumor. Detailed clinical information was systematically reviewed and analyzed. Serum concentrations of neutrophil gelatinase-associated lipocalin (NGAL) and creatinine (sCr) were tested before, 2 hours and 1 day after PN surgery. Perioperative anaemia was assessed according to haematocrit (Ht) value at the same timepoint. Association between perioperative anaemia and postoperative AKI were explored by logistic regression analyses and pearson correlation analysis. Results The rate of perioperative anaemia in patients undergoing PN was 35.3% when the criteria of Ht < 30% was adopted. AKI developed in 32.4% of the patients when KDIGO criteria was applicated and in 51.5% of the patients when the criteria of serum NGAL >150 ng/mL was used. The incidence of AKI in patients with perioperative anaemia was higher than that in patients without anaemia. Univariate logistic regression analyses showed perioperative anaemia was a relevant factor of postoperative AKI in patients undergoing PN.Conclusions Perioperative anaemia might be a risk factor of postoperative AKI after PN. But the detailed interrelation still needs to be verified by large-scale prospective studies.