Urinary NephroCheck® test, as a marker of subclinical postoperative AKI, correlates with long-term GFR decline in patients undergoing partial nephrectomy: a prospective bicentric observational study
Abstract Background Nephron-sparing surgery (NSS) represents the preferred technique to treat localized renal lesions, not being exempted from the risk of postoperative acute kidney injury (AKI) to happen, though. Patients experiencing postoperative AKI, either clinical or subclinical, are more susc...
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BMC
2025-07-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-025-04242-9 |
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| author | Marco Allinovi Margarete Teresa Walach Micaela Anna Casiraghi Marc Weidenbusch Samantha Innocenti Lorenzo Tofani Laura Paparella Alessandra Fanelli Gianluca Villa Philipp Nuhn |
| author_facet | Marco Allinovi Margarete Teresa Walach Micaela Anna Casiraghi Marc Weidenbusch Samantha Innocenti Lorenzo Tofani Laura Paparella Alessandra Fanelli Gianluca Villa Philipp Nuhn |
| author_sort | Marco Allinovi |
| collection | DOAJ |
| description | Abstract Background Nephron-sparing surgery (NSS) represents the preferred technique to treat localized renal lesions, not being exempted from the risk of postoperative acute kidney injury (AKI) to happen, though. Patients experiencing postoperative AKI, either clinical or subclinical, are more susceptible to develop chronic kidney disease. Methods Patients scheduled for NSS in localized renal cell carcinoma were recruited. Patients were grouped according to postoperative AKI development and postoperative NephroCheck value: group 1 (normal), no AKI and no increased biomarker; group 2 (subclinical AKI), no AKI but increased NephroCheck (> 0.3 at 4 h postoperatively); group 3, AKI and no increased NephroCheck; group 4 (clinical AKI), AKI and increased NephroCheck. Samples were collected pre- and post-operatively; renal function was re-assessed up to 24 months. Results Among 131 patients included, 42% developed clinical AKI. Based on NephroCheck® and clinical AKI criteria, patients could be divided in four groups with significantly different eGFR at 24 months (p = 0.0003). Multivariate analysis confirmed clinical AKI as an independent predictor of eGFR decline at 24 months (p < 0.0003). In subclinical AKI’s subgroup [20/131 (15%)], characterized by urinary NephroCheck® >0.3 and serum creatinine increase < 0.3 mg/dL, NephroCheck® appeared as an independent predictor of severe eGFR decline at 24 months (OR 3.76, p = 0.02); in this subgroup, eGFR decline resulted significantly more severe compared to eGFR decline in patients with neither serum creatinine nor tubular damage markers’ elevation. Conclusions In patients undergoing NSS, the most reliable predictor of long-term eGFR decline is represented by the occurrence of postoperative clinical AKI. In this setting, NephroCheck® appeared able to identify ‘subclinical AKI’ and consequently patients at increased risk of 24-month-eGFR decline. |
| format | Article |
| id | doaj-art-0ac97ffca13f4fe7821cfed06bcb79e8 |
| institution | Kabale University |
| issn | 1471-2369 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj-art-0ac97ffca13f4fe7821cfed06bcb79e82025-08-20T04:01:25ZengBMCBMC Nephrology1471-23692025-07-012611910.1186/s12882-025-04242-9Urinary NephroCheck® test, as a marker of subclinical postoperative AKI, correlates with long-term GFR decline in patients undergoing partial nephrectomy: a prospective bicentric observational studyMarco Allinovi0Margarete Teresa Walach1Micaela Anna Casiraghi2Marc Weidenbusch3Samantha Innocenti4Lorenzo Tofani5Laura Paparella6Alessandra Fanelli7Gianluca Villa8Philipp Nuhn9Nephrology, Dialysis and Transplantation Unit, Careggi University HospitalDepartment of Urology and Urologic Surgery, University Medical Centre Mannheim (UMM), Medical Faculty Mannheim of Heidelberg UniversityNephrology, Dialysis and Transplantation Unit, Careggi University HospitalNephrologisches Zentrum, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians UniversityNephrology, Dialysis and Transplantation Unit, Careggi University HospitalDepartment of Anaesthesia and Intensive Care, Careggi University HospitalDepartment of Anaesthesia and Intensive Care, Careggi University HospitalLaboratory Department, Careggi University HospitalDepartment of Anaesthesia and Intensive Care, Careggi University HospitalKlinik für Urologie Kiel, Universitätsklinikum Schleswig-HolsteinAbstract Background Nephron-sparing surgery (NSS) represents the preferred technique to treat localized renal lesions, not being exempted from the risk of postoperative acute kidney injury (AKI) to happen, though. Patients experiencing postoperative AKI, either clinical or subclinical, are more susceptible to develop chronic kidney disease. Methods Patients scheduled for NSS in localized renal cell carcinoma were recruited. Patients were grouped according to postoperative AKI development and postoperative NephroCheck value: group 1 (normal), no AKI and no increased biomarker; group 2 (subclinical AKI), no AKI but increased NephroCheck (> 0.3 at 4 h postoperatively); group 3, AKI and no increased NephroCheck; group 4 (clinical AKI), AKI and increased NephroCheck. Samples were collected pre- and post-operatively; renal function was re-assessed up to 24 months. Results Among 131 patients included, 42% developed clinical AKI. Based on NephroCheck® and clinical AKI criteria, patients could be divided in four groups with significantly different eGFR at 24 months (p = 0.0003). Multivariate analysis confirmed clinical AKI as an independent predictor of eGFR decline at 24 months (p < 0.0003). In subclinical AKI’s subgroup [20/131 (15%)], characterized by urinary NephroCheck® >0.3 and serum creatinine increase < 0.3 mg/dL, NephroCheck® appeared as an independent predictor of severe eGFR decline at 24 months (OR 3.76, p = 0.02); in this subgroup, eGFR decline resulted significantly more severe compared to eGFR decline in patients with neither serum creatinine nor tubular damage markers’ elevation. Conclusions In patients undergoing NSS, the most reliable predictor of long-term eGFR decline is represented by the occurrence of postoperative clinical AKI. In this setting, NephroCheck® appeared able to identify ‘subclinical AKI’ and consequently patients at increased risk of 24-month-eGFR decline.https://doi.org/10.1186/s12882-025-04242-9Acute kidney injuryPartial nephrectomyRenal cell carcinomaTIMP-2IGFBP7NephroCheck |
| spellingShingle | Marco Allinovi Margarete Teresa Walach Micaela Anna Casiraghi Marc Weidenbusch Samantha Innocenti Lorenzo Tofani Laura Paparella Alessandra Fanelli Gianluca Villa Philipp Nuhn Urinary NephroCheck® test, as a marker of subclinical postoperative AKI, correlates with long-term GFR decline in patients undergoing partial nephrectomy: a prospective bicentric observational study BMC Nephrology Acute kidney injury Partial nephrectomy Renal cell carcinoma TIMP-2 IGFBP7 NephroCheck |
| title | Urinary NephroCheck® test, as a marker of subclinical postoperative AKI, correlates with long-term GFR decline in patients undergoing partial nephrectomy: a prospective bicentric observational study |
| title_full | Urinary NephroCheck® test, as a marker of subclinical postoperative AKI, correlates with long-term GFR decline in patients undergoing partial nephrectomy: a prospective bicentric observational study |
| title_fullStr | Urinary NephroCheck® test, as a marker of subclinical postoperative AKI, correlates with long-term GFR decline in patients undergoing partial nephrectomy: a prospective bicentric observational study |
| title_full_unstemmed | Urinary NephroCheck® test, as a marker of subclinical postoperative AKI, correlates with long-term GFR decline in patients undergoing partial nephrectomy: a prospective bicentric observational study |
| title_short | Urinary NephroCheck® test, as a marker of subclinical postoperative AKI, correlates with long-term GFR decline in patients undergoing partial nephrectomy: a prospective bicentric observational study |
| title_sort | urinary nephrocheck r test as a marker of subclinical postoperative aki correlates with long term gfr decline in patients undergoing partial nephrectomy a prospective bicentric observational study |
| topic | Acute kidney injury Partial nephrectomy Renal cell carcinoma TIMP-2 IGFBP7 NephroCheck |
| url | https://doi.org/10.1186/s12882-025-04242-9 |
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