C-reactive Protein/Albumin Ratio and Acute Kidney Injury after Radical Cystectomy among Elderly Patients: A Propensity Score-Matched Analysis. (28th October 2020)

• Record Type: Journal Article
• Authors: Yu, Jihion; Park, Jun-Young; Ha, Seungsoo; Hwang, Jai-Hyun; Kim, Young-Kug
• Other Names: Shi Mingjun Academic Editor.
• Is Part Of: Disease markers. Volume 2020(2020)
• Publication Date: 2020-10-28
• Subjects: Diagnosis -- Periodicals; Biochemical markers -- Periodicals; Pathology -- Periodicals; 616
• DOI: 10.1155/2020/8818445
• Languages: English
• ISSNs: 0278-0240

Abstract

Abstract : Background . The C-reactive protein (CRP)/albumin ratio is a useful index used to represent patient inflammation and nutritional status. Elderly patients are at the highest risk for acute kidney injury (AKI). We clarified the impact of the preoperative CRP/albumin ratio on AKI and evaluated the impact of postoperative AKI on end-stage renal disease (ESRD) among elderly cystectomy patients. Methods . We included elderly patients ≥ 65 years of age who underwent radical cystectomy. Multivariate logistic regression analysis and receiver operating characteristic curve analysis were performed to identify risk factors for AKI. Propensity score-matched analysis and conditional logistic regression analysis were performed to elucidate the impact of the CRP/albumin ratio on AKI. The incidence of ESRD was compared between the non-AKI and AKI groups at 12 months after radical cystectomy. Results . AKI occurred in 110 patients (32.2%). The CRP/albumin ratio and 6% hydroxyethyl starch amount were risk factors for postoperative AKI. The optimal cut-off value for the CRP/albumin ratio predicting AKI was 0.1. After propensity score matching, the AKI incidence in the CRP/albumin ratio ≥ 0.1 group was higher than that in the CRP/albumin ratio < 0.1 group (46.7% vs. 20.6%, P < 0.001 ), and a CRP/albumin ratio ≥ 0.1 was associated with a higher AKI incidence (odds ratio = 4.111, P < 0.001 ). The ESRD incidence was higher in the AKI group than in the non-AKI group (7.3% vs. 1.2%, P = 0.017 ). Conclusion . A CRP/albumin ratio ≥ 0.1 was associated with an increased incidence of AKI, which was associated with higher ESRD incidence among elderly cystectomy patients.