Novel Biomarkers and Postoperative Kidney Injury in Radical Nephrectomy

Peking University First Hospital60 enrolled

Overview

The incidence of acute kidney injury (AKI) after radical nephrectomy exceeds 40%. Currently, the KDIGO criteria are the recognized diagnostic standard for AKI. These criteria primarily use serum creatinine and urine output as key indicators, but both parameters have certain limitations, such as delayed response, insensitivity, and inaccuracy. This study aims to simultaneously monitor perioperative novel renal damaging, stressful, and functional biomarkers in patients undergoing radical nephrectomy, and to investigate their predictive value for AKI and postoperative 1-year chronic kidney disease (CKD).

Study Type

OBSERVATIONAL

Enrollment

Conditions

Nephrectomy Acute Kidney Injury Biomarker

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age ≥18 years; * Scheduled to undergo unilateral radical nephrectomy. Exclusion Criteria: * Solitary kidney; * Preoperative diagnosis of chronic kidney disease stages G4 or G5 (GFR \<30 mL/min/1.73m²); * Tumor invasion of the vena cava requiring thrombectomy; * Other conditions deemed by the investigator as unsuitable for participation in this study.

Locations (1)

Outcomes

Primary Outcomes

The urinary [TIMP-2]×[IGFBP-7], urinary NGAL, urinary KIM-1, serum cystatin C and their combinations to predict postoperative AKI occurring within 7 days.

Novel biomarkers above were collected at the end of surgery, and at postoperative 1h, 6h, and 20h. AKI diagnosed according to 2012 KDIGO criteria (occurring within 7 days after surgery).

Time frame: Up to 7 days after surgery.

Secondary Outcomes

The urinary [TIMP-2]×[IGFBP-7], urinary NGAL, urinary KIM-1, serum cystatin C and their combinations to predict new onset/worsening CKD occurring within 1 year after surgery.

Novel biomarkers above were collected before and at the end of surgery, and at postoperative 1h, 6h, and 20h. CKD diagnosed according to 2024 KDIGO-CKD criteria (occurring within 1 year after surgery).

Time frame: Up to 1 year after surgery

The urinary [TIMP-2]×[IGFBP-7], urinary NGAL, urinary KIM-1, serum cystatin C combined with clinically important risk factors to predict postoperative AKI occurring within 7 days after surgery.

Novel biomarkers above were collected before and at the end of surgery, and at postoperative 1h, 6h, and 20h. AKI diagnosed according to 2012 KDIGO criteria (occurring within 7 days after surgery).