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Analysis of factors associated with postoperative acute kidney injury in patients with colorectal cancer and the development of a risk prediction model: a retrospective study

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Abstract

Background

To investigate the factors associated with acute kidney injury (AKI) in postoperative colorectal cancer (CRC) patients and develop a risk prediction model.

Methods

The clinical data of 389 CRC patients were retrospectively analyzed. The patients were divided into AKI (n = 30) and non-AKI groups (n = 359) according to KDIGO diagnostic criteria. Demographic data, the presence of underlying diseases, perioperative conditions and related examination results were compared between the two groups. Binary logistic regression was used to analyze the independent risk factors for postoperative AKI, and a risk prediction model was established. And a verification group (94 patients) was used to verify the model.

Results

30 patients (7.71%) with CRC had postoperative AKI. Binary logistic regression analysis showed that preoperative combined hypertension, preoperative anemia, inadequate intraoperative crystalloid infusion, low intraoperative minimum mean arterial pressure (MAP) and moderate to severe postoperative decline in hemoglobin (Hb) levels were independent risk factors. The risk prediction model developed was expressed as Logit P = − 0.853 + 1.228 * preoperative combined hypertension + 1.275 *preoperative anemia − 0.002 * intraoperative crystalloid infusion (ml) − 0.091 * intraoperative minimum MAP (mmHg) + 1.482 * moderate to severe postoperative decline in Hb levels. In Hosmer–Lemeshow test, χ2 = 8.157, P = 0.718 showed that the fitting effect was good. The area under ROC curve was 0.776 (95% CI 0.682–0.871, P < 0.001), with a prediction threshold of 1.570, a sensitivity of 63.3% and a specificity of 88.9%. The sensitivity and specificity of the verification group were 65.8% and 86.1%.

Conclusions

Preoperative combined hypertension, preoperative anemia, inadequate intraoperative crystalloid infusion, low intraoperative minimum MAP, and moderate to severe postoperative decline in Hb levels were independent risk factors for AKI development in CRC patients. The prediction model can effectively predict the occurrence of postoperative AKI in patients with CRC.

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Upon reasonable request, data and methodology can be shared. All data are available from the author.

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Funding

This work was supported by the Advanced Programs for the Returned Overseas Chinese Scholars of Henan Province with Grant number 2017-9.

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Authors and Affiliations

  1. Department of General Surgery, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, 127 Dongming Road, Zhengzhou City, 450008, Henan Province, China

    Liu Li, Xiaochen Wan, Yonglei Zhang, Minghai Zhao, Jinjun Ren & Yongchao Zhang

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  1. Liu Li
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  2. Xiaochen Wan
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  3. Yonglei Zhang
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  4. Minghai Zhao
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  5. Jinjun Ren
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Correspondence to Yongchao Zhang.

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The authors declare no competing financial interests.

Research involving human participants and/or animals, and Informed consent

This study was approved by the ethics committees of the Affliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China. Due to the retrospective nature of the study and because no patient specimens were used, the requirement for informed consent was waived by the ethics committees. So the patients signed informed consents form that we created (unofficially).

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Li, L., Wan, X., Zhang, Y. et al. Analysis of factors associated with postoperative acute kidney injury in patients with colorectal cancer and the development of a risk prediction model: a retrospective study. Updates Surg 75, 1171–1178 (2023). https://doi.org/10.1007/s13304-023-01481-z

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  • DOI: https://doi.org/10.1007/s13304-023-01481-z

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