LAUSR

Acute kidney injury (AKI) due to nephrectomy is associated with adverse prognosis. The study aimed to develop a nomogram based on preprocedural features for early prediction of AKI and to assess the prognosis in patients after nephrectomy. The study included a development cohort of 1111 patients and an additional validation cohort of 356 patients who underwent nephrectomy. Stepwise and logistic regression analyses were used to evaluate the association between predictors and AKI. Incorporating all independent predictors, a nomogram for postoperative AKI was developed and validated. Patients were followed up for 5 years to assess renal fuction, acute kidney disease (AKD), chronic kidney disease (CKD), hospital readmission and death were key prognostic outcomes we focused on. Radical nephrectomy (odds ratio (OR) = 3.57, p < 0.001), aspirin (OR = 1.79, p = 0.008), systolic blood pressure (OR = 1.41, p = 0.004), triglyceride (OR = 1.26, p = 0.024) were independent risk factors for postoperative AKI, while albumin (OR = 0.72, p = 0.031) was a protective factor for postoperative AKI. Patients with a higher estimated glomerular filtration rate (eGFR) (60-90 ml/min/1.73 m2, OR = 0.41, p = 0.004; ≥ 90 ml/min/1.73 m2, OR = 0.37, p < 0.001) were less prone to AKI than those with a lower eGFR (< 15 ml/min/1.73 m2). These predictors were all included in the final nomogram to calculate the probability of postoperative AKI. The incidence of AKD and CKD were 27.12% and 18.64% in AKI group, which were much higher than those in no AKI group (p < 0.001). The nomogram had excellent predictive ability and might have significant clinical implications for the early detection of AKI in patients undergoing nephrectomy.