Abstract
Background: Acute kidney injury (AKI) frequently occurs in several medical and surgical settings, and it is associated with increased morbidity and mortality. In patients undergoing lung cancer surgery, AKI has not been fully investigated. We prospectively evaluated the incidence, clinical relevance, and risk factors of AKI in patients undergoing lung cancer surgery. Moreover, we estimated the accuracy of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the prediction of AKI. Methods: Patients undergoing lung cancer surgery were included in the study. Plasma NT-proBNP was measured before and soon after surgery. Postoperative AKI was defined according to the Acute Kidney Injury Network (AKIN) classification. Results: A total of 2179 patients were enrolled. Of them, 222 (10%) developed AKI and had a more complicated in-hospital clinical course (overall complication rate: 35% vs. 16%; P < 0.0001), and a longer hospital stay (10 ± 7 vs. 7 ± 4 days; P < 0.0001). The incidence of AKI increased in parallel with the extent of lung resection. Among the independent predictors of AKI, serum creatinine (area under the curve [AUC] 0.70 [95% CI 0.67-0.74]) and NT-proBNP (AUC 0.71 [95% CI 0.67-0.74]) provided the highest predictive accuracy, and their combination further significantly improved AKI prediction (AUC 0.74 [95% CI 0.71-0.77]). No difference in AKI prediction was observed between preoperative and postoperative NT-proBNP (P = 0.84). Conclusions: Acute kidney injury occurs in 10% of patients undergoing lung cancer surgery, and it is associated with a high incidence of postoperative complications. The risk of AKI can be accurately predicted by the combined evaluation of preoperative serum creatinine and NT-proBNP.
| Original language | English |
|---|---|
| Pages (from-to) | 155-159 |
| Number of pages | 5 |
| Journal | Lung Cancer |
| Volume | 123 |
| DOIs | |
| Publication status | Published - Sep 1 2018 |
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Keywords
- Acute kidney injury
- Lung cancer surgery
- N-terminal pro-B-type natriuretic peptide
- serum creatinine
ASJC Scopus subject areas
- Oncology
- Pulmonary and Respiratory Medicine
- Cancer Research
Cite this
Acute kidney injury after lung cancer surgery : Incidence and clinical relevance, predictors, and role of N-terminal pro B-type natriuretic peptide. / Cardinale, Daniela; Cosentino, Nicola; Moltrasio, Marco; Sandri, Maria Teresa; Petrella, Francesco; Colombo, Alessandro; Bacchiani, Giulia; Tessitore, Adele; Bonomi, Alice; Veglia, Fabrizio; Salvatici, Michela; Cipolla, Carlo M.; Marenzi, Giancarlo; Spaggiari, Lorenzo.
In: Lung Cancer, Vol. 123, 01.09.2018, p. 155-159.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Acute kidney injury after lung cancer surgery
T2 - Incidence and clinical relevance, predictors, and role of N-terminal pro B-type natriuretic peptide
AU - Cardinale, Daniela
AU - Cosentino, Nicola
AU - Moltrasio, Marco
AU - Sandri, Maria Teresa
AU - Petrella, Francesco
AU - Colombo, Alessandro
AU - Bacchiani, Giulia
AU - Tessitore, Adele
AU - Bonomi, Alice
AU - Veglia, Fabrizio
AU - Salvatici, Michela
AU - Cipolla, Carlo M.
AU - Marenzi, Giancarlo
AU - Spaggiari, Lorenzo
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Background: Acute kidney injury (AKI) frequently occurs in several medical and surgical settings, and it is associated with increased morbidity and mortality. In patients undergoing lung cancer surgery, AKI has not been fully investigated. We prospectively evaluated the incidence, clinical relevance, and risk factors of AKI in patients undergoing lung cancer surgery. Moreover, we estimated the accuracy of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the prediction of AKI. Methods: Patients undergoing lung cancer surgery were included in the study. Plasma NT-proBNP was measured before and soon after surgery. Postoperative AKI was defined according to the Acute Kidney Injury Network (AKIN) classification. Results: A total of 2179 patients were enrolled. Of them, 222 (10%) developed AKI and had a more complicated in-hospital clinical course (overall complication rate: 35% vs. 16%; P < 0.0001), and a longer hospital stay (10 ± 7 vs. 7 ± 4 days; P < 0.0001). The incidence of AKI increased in parallel with the extent of lung resection. Among the independent predictors of AKI, serum creatinine (area under the curve [AUC] 0.70 [95% CI 0.67-0.74]) and NT-proBNP (AUC 0.71 [95% CI 0.67-0.74]) provided the highest predictive accuracy, and their combination further significantly improved AKI prediction (AUC 0.74 [95% CI 0.71-0.77]). No difference in AKI prediction was observed between preoperative and postoperative NT-proBNP (P = 0.84). Conclusions: Acute kidney injury occurs in 10% of patients undergoing lung cancer surgery, and it is associated with a high incidence of postoperative complications. The risk of AKI can be accurately predicted by the combined evaluation of preoperative serum creatinine and NT-proBNP.
AB - Background: Acute kidney injury (AKI) frequently occurs in several medical and surgical settings, and it is associated with increased morbidity and mortality. In patients undergoing lung cancer surgery, AKI has not been fully investigated. We prospectively evaluated the incidence, clinical relevance, and risk factors of AKI in patients undergoing lung cancer surgery. Moreover, we estimated the accuracy of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the prediction of AKI. Methods: Patients undergoing lung cancer surgery were included in the study. Plasma NT-proBNP was measured before and soon after surgery. Postoperative AKI was defined according to the Acute Kidney Injury Network (AKIN) classification. Results: A total of 2179 patients were enrolled. Of them, 222 (10%) developed AKI and had a more complicated in-hospital clinical course (overall complication rate: 35% vs. 16%; P < 0.0001), and a longer hospital stay (10 ± 7 vs. 7 ± 4 days; P < 0.0001). The incidence of AKI increased in parallel with the extent of lung resection. Among the independent predictors of AKI, serum creatinine (area under the curve [AUC] 0.70 [95% CI 0.67-0.74]) and NT-proBNP (AUC 0.71 [95% CI 0.67-0.74]) provided the highest predictive accuracy, and their combination further significantly improved AKI prediction (AUC 0.74 [95% CI 0.71-0.77]). No difference in AKI prediction was observed between preoperative and postoperative NT-proBNP (P = 0.84). Conclusions: Acute kidney injury occurs in 10% of patients undergoing lung cancer surgery, and it is associated with a high incidence of postoperative complications. The risk of AKI can be accurately predicted by the combined evaluation of preoperative serum creatinine and NT-proBNP.
KW - Acute kidney injury
KW - Lung cancer surgery
KW - N-terminal pro-B-type natriuretic peptide
KW - serum creatinine
UR - http://www.scopus.com/inward/record.url?scp=85050104470&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85050104470&partnerID=8YFLogxK
U2 - 10.1016/j.lungcan.2018.07.009
DO - 10.1016/j.lungcan.2018.07.009
M3 - Article
AN - SCOPUS:85050104470
VL - 123
SP - 155
EP - 159
JO - Lung Cancer
JF - Lung Cancer
SN - 0169-5002
ER -