Serum and urinary biomarkers for predicting acute kidney injury after partial nephrectomy

Chen, Jinzhuan; Lin, Jianqing; Lin, Chuan-Yan

doi:10.25011/cim.v38i3.22703

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…Secondly, the improvement of surgeons' skill and surgical technique helped preserve renal function. For example, the durations of renal hilus clamping and surgery were shorter in our patients than in previous studies [8,24,25].…”

Section: Discussioncontrasting

confidence: 68%

“…Routine circulatory management during partial nephrectomy is to maintain blood pressure change within 20% from baseline and urine output > 0.5 ml/kg/h. However, the incidence of AKI remains high after surgery [8,24,25]. Experience from kidney transplantation suggested that maintaining adequate renal hydration and higher blood pressure after reperfusion (i.e., CVP > 8 mmHg and MAP > 95 mmHg) are bene cial for graft function [14,15,18].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of Goal-directed Hemodynamic Management on the Incidence of Acute Kidney Injury in Patients Undergoing Partial Nephrectomy: A Pilot Randomized Controlled Trial

Kong

et al. 2020

Preprint

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Background: The incidence of acute kidney injury (AKI) remains high after partial nephrectomy. Ischemia-reperfusion injury produced by renal hilum clamping during surgery might have contributed to the development of AKI. In this study we tested the hypothesis that goal-directed fluid and blood pressure management could reduce AKI in patients following partial nephrectomy. Methods: This was a pilot randomized controlled trial. Adult patients who were scheduled to undergo partial nephrectomy were randomized into two groups. In the intervention group, goal-directed hemodynamic management was performed from renal hilum clamping until end of surgery; the target was to maintain stroke volume variation < 6%, cardiac index 3.0 - 4.0 L/min/m2 and mean arterial pressure > 95mmHg with crystalloid fluids and infusion of dobutamine and/or norepinephrine. In the control group, hemodynamic management was performed according to routine practice. The primary outcome was the incidence of AKI within the first 3 postoperative days. Results: From June 2016 to January 2017, 144 patients were enrolled and randomized (intervention group, n = 72, control group, n = 72). AKI developed in 12.5% of patients in the intervention group and in 20.8% of patients in the control group; the relative reduction of AKI was 39.9% in the intervention group but the difference was not statistically significant (relative risk 0.60, 95% confidence interval [CI] 0.28-1.28; P = 0.180). No significant differences were found regarding AKI classification, change of estimated glomerular filtration rate over time, incidence of postoperative 30-day complications, postoperative length of hospital stay, as well as 30-day and 6-month mortality between the two groups.Conclusion: For patients undergoing partial nephrectomy, goal-directed circulatory management during surgery reduced postoperative AKI by about 40%, although not significantly so. The trial was underpowered. Large sample size randomized trials are needed to confirm our results.Trial registration: Clinicaltrials.gov identifier: NCT02803372. Date of registration: June 6, 2016.

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Section: Discussioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Impact of Goal-directed Hemodynamic Management on the Incidence of Acute Kidney Injury in Patients Undergoing Partial Nephrectomy: A Pilot Randomized Controlled Trial

Kong

et al. 2020

Preprint

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“…Thirty studies161718192021222324252627282930313233343536373839404142434445 finally met the inclusion criteria via full-text evaluation from 156 potentially eligible citations. Seven studies21222324252627 were selected from the previous meta-analysis (Zhang, et al .…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies21222324252627 were selected from the previous meta-analysis (Zhang, et al . 2011)15 and an additional 23 studies1617181920282930313233343536373839404142434445 were complemented in the present meta-analysis. A flow chart of the identification and selection process is shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

Predictive value of serum cystatin C for acute kidney injury in adults: a meta-analysis of prospective cohort trials

Yong

Pei

Zhu

et al. 2017

Sci Rep

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The role of serum cystatin C (Scys) for the detection of acute kidney injury (AKI) has not been fully discussed. This meta-analysis was aimed to investigate the overall diagnostic accuracy of Scys for AKI in adults, and further identify factors affecting its performance. Studies before Sept. 2016 were retrieved from PubMed, Embase, Web of Science and the Cochrane Library. A total of 30 prospective cohort studies (involving 4247 adults from 15 countries, 982 patients occurring AKI) were included. The revised Quality Assessment for Studies of Diagnostic Accuracy (QUADAS-2) tools demonstrated no significant bias had influenced the methodological quality of the included studies. Scys showed a high predictive power for all-cause AKI, that the area under the receiver operating characteristic curve was 0.89. The detailed assessment parameters, such as sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for Scys were 0.82, 0.82, 4.6, 0.22 and 21, respectively. Although Scys could be slightly influenced by the following factors: settings, AKI diagnostic criteria, ethnicity, determination method, age and gender, these factors above did not reach statistically significance. In conclusion, Scys could be a vital promising marker to screen out AKI.

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“…Unilateral nepherectomy was done according to Chen et al [23]. Rats were anesthetized with sodium pentobarbital (50 mg/kg body weight; ip).…”

Section: Unilateral Nepherectomymentioning

confidence: 99%

Egyptian Pyramid Model Housing Enhancing the Compensatory Renal Growth in Nephrectomized Rats

Margaret¹

2016

JCMAH

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The present study aims to evaluate the role of the Egyptian pyramids housing on the enhancement of reno-regenerative ability after unilateral nephrectomy in rats. Forty two male Wistar rats were assigned equally into three main groups (14 rats for each).The sham-operated control (sham group) and unilateral nephrectomized rats (Nx group). Both groups maintained in their home cages for 7 and 14 days. The third group(Pyramid housed group) in which Nx rats housed within the wooden pyramid (6 hr/day)for 7 and 14 days. The present study showed significant increase in size of the remaining kidney, rate of sodium excretion and marked increase in urea, uric acid and creatinine levels in the serum of Nx rats. In addition, significant decrease in renin-angiotensin-aldosterone system was also recorded following nephrectomy for 7 and 14 days. Pyramid environment reversed the actions of nephrectomy in rats and restored the kidney function near the sham levels. In conclusion: The present study recommends using pyramidal shapes for nephrectomized individual's rooms immediately following the surgery and during the recovery periods to avoid kidney impairment as consequence of nephrectomy process.

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Serum and urinary biomarkers for predicting acute kidney injury after partial nephrectomy

Cited by 8 publications

References 19 publications

Impact of Goal-directed Hemodynamic Management on the Incidence of Acute Kidney Injury in Patients Undergoing Partial Nephrectomy: A Pilot Randomized Controlled Trial

Impact of Goal-directed Hemodynamic Management on the Incidence of Acute Kidney Injury in Patients Undergoing Partial Nephrectomy: A Pilot Randomized Controlled Trial

Predictive value of serum cystatin C for acute kidney injury in adults: a meta-analysis of prospective cohort trials

Egyptian Pyramid Model Housing Enhancing the Compensatory Renal Growth in Nephrectomized Rats

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