Mp51-08 External Validation of Rensafe: A Tool to Predict Acute Kidney Injury and Chronic Kidney Disease >3b Post Partial or Radical Nephrectomy

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance II (MP51)1 May 2024MP51-08 EXTERNAL VALIDATION OF RENSAFE: A TOOL TO PREDICT ACUTE KIDNEY INJURY AND CHRONIC KIDNEY DISEASE >3B POST PARTIAL OR RADICAL NEPHRECTOMY Jonathan Afari, Cesare Saitta, Sabrina Noyes, Margaret Meagher, Kit Yuen, Jacob Roberts, Ryan Nasseri, Dhruv Puri, Kevin Hakimi, Josh Matian, Michael Liss, Tom B. McGregor, Deepak Pruthi, Brian R. Lane, and Ithaar Derweesh Jonathan AfariJonathan Afari , Cesare SaittaCesare Saitta , Sabrina NoyesSabrina Noyes , Margaret MeagherMargaret Meagher , Kit YuenKit Yuen , Jacob RobertsJacob Roberts , Ryan NasseriRyan Nasseri , Dhruv PuriDhruv Puri , Kevin HakimiKevin Hakimi , Josh MatianJosh Matian , Michael LissMichael Liss , Tom B. McGregorTom B. McGregor , Deepak PruthiDeepak Pruthi , Brian R. LaneBrian R. Lane , and Ithaar DerweeshIthaar Derweesh View All Author Informationhttps://doi.org/10.1097/01.JU.0001009492.49624.4b.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The RENSAFE (RENalSAFEty) nomogram series has recently been published (PMID: 37880003) as a cost-effective model capable of predicting acute kidney injury (AKI) and chronic kidney disease ≥3b (CKD) after partial (PN) or radical nephrectomy (RN). We sought to externally validate RENSAFE. METHODS: Primary objective was to compare the accuracy of the initial study by comparing the initial study population to a new cohort and to determine the generalizability of the nomogram model (HYPERLINK "https://cesare95.pythonanywhere.com/" RENSAFE Score Calculator (cesare95.pythonanywhere.com; Figure 1). For the validation cohort, stepwise logistic regression was conducted for AKI (reduction>25% of preoperative eGFR) and de novo CKD ≥3b (<45 ml/min/1.73 m2), through stepwise logistic regression. Accuracy was tested with receiver operator characteristic area under the curve (AUC). RESULTS: Comparing Validation and Publication cohorts, AKI occurred in 607/1,887 (32.2%) vs 452/1517 (29.8%) and de novo CKD ≥3b in 301/1,523 (19.8%) vs 116/903 (12.8%) patients. Logistic regression demonstrated ASA class (OR 1.32, p=0.039 vs OR 1.3, p<0.001), hypertension (OR 1.33, p=0.038 vs OR 1.6, p<0.001), RENAL score (OR 1.2, p<0.001 vs OR 1.2, p<0.001), preoperative eGFR <60 (OR 1.83, p<0.001 vs OR 1.8, p=0.009), and RN (OR 11.1, p<0.001 vs OR 10.4, p<0.001) as predictors for AKI. Age (OR 1.03, p<0.001 vs OR 1.01, p<0.001), diabetes mellitus (OR 1.8, p=0.007 vs OR 2.5, p<0.001), preoperative eGFR <60 (OR 6.8, p<0.001 vs OR 3.6, p<0.001) and RN (OR 4.1, p<0.001 vs OR 2.2, p<0.01) were predictors for CKD ≥3b. Comparing AUC of Validation and publication cohorts for RENSAFE AKI and CKD were 0.80 vs. 0.80 and 0.81 vs. 0.76, respectively (Figure 1). CONCLUSIONS: RENSAFE nomogram is a valid tool for predicting post-surgical AKI and de novo CKD ≥3b and showed a higher performance for de novo CKD ≥3b in the validation cohort. RENSAFE may be reliably integrated into clinical practice to guide shared decision making and selection of RN and PN. Download PPT Source of Funding: Weissman Kidney Cancer Institute © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e844 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Jonathan Afari More articles by this author Cesare Saitta More articles by this author Sabrina Noyes More articles by this author Margaret Meagher More articles by this author Kit Yuen More articles by this author Jacob Roberts More articles by this author Ryan Nasseri More articles by this author Dhruv Puri More articles by this author Kevin Hakimi More articles by this author Josh Matian More articles by this author Michael Liss More articles by this author Tom B. McGregor More articles by this author Deepak Pruthi More articles by this author Brian R. Lane More articles by this author Ithaar Derweesh More articles by this author Expand All Advertisement PDF downloadLoading ...