RISK GROUPS OF ACUTE KIDNEY INJURY IN PATIENTS AFTER OPERATIVE THERAPY OF TUMORS OF A SOLITARY KIDNEY

The objective of this study is to devise a prognostic classification of AKI in the postoperative period based on preoperative factors for patients after partial nephrectomy for renal masses in the solitary kidney (SK). This method will allow identifying patients in a high risk group and reducing this unfavorable postoperative outcome by a careful treatment planning.

We present a series of 136 patients with SK tumor who underwent open partial nephrectomy in situ performed at the N. N. Alexandrov National Cancer Centre of Belarus in 2000–2016. 

During the early postoperative period, AKI occurred in 28 (20.6 %) patients. Three risk factors associated with a risk of developing AKI were included in the multivariate analysis: categorized risk factors such as tumor size and serum potassium and dichotomous – multifocality. On the basis of the multivariant model presented, 3 risk factors were assigned a weighted score. Depending on the score, the cohort of patients was divided into 3 groups. Patients with a score from 0 to 2 were classified as a low-risk group, 3 points – an intermediate-risk group and ≥4 points – a high-risk group with the development of AKI in the postoperative period.

The devised prognostic classification allows one during the preoperative period with a predictive accuracy of 82.3 % to determine a risk of development of AKI after partial nephrectomy of SK. In the low-risk group, the probability of developing AKI after surgery is 5.6 %, in the intermediate-risk group – 2.9 %, in the high-risk group – 68.2 % (р < 0.001).

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