C-reactive Protein/Albumin Ratio and Acute Kidney Injury after Radical Cystectomy among Elderly Patients: A Propensity Score-Matched Analysis

• Published in: Disease markers 2020, Vol.2020 (2020), p.1-11
• Main Authors: Hwang, Jai-Hyun, Ha, Seungsoo, Park, Jun-Young, Yu, Jihion, Kim, Young-Kug
• Format: Article
• Language: English
• Subjects: Acute Kidney Injury - epidemiology; Acute Kidney Injury - etiology; Acute Kidney Injury - metabolism; Age; Aged; Aged, 80 and over; Albumin; Albumins; Bladder cancer; Blood pressure; C-reactive protein; C-Reactive Protein - metabolism; Cancer therapies; Chemotherapy; Creatinine; Dissection; End-stage renal disease; Female; General anesthesia; Health risks; Humans; Hydroxyethyl starch; Hypotension; Incidence; Inflammation; Injury analysis; Intubation; Kidney diseases; Kidney Failure, Chronic - epidemiology; Kidney Failure, Chronic - etiology; Kidney Failure, Chronic - metabolism; Kidneys; Logistic Models; Lymphatic system; Male; Medical personnel; Mortality; Multivariate Analysis; Nonsteroidal anti-inflammatory drugs; Nutritional status; Older people; Patients; Propensity Score; Proteins; Regression analysis; Risk analysis; Risk factors; Serum Albumin, Human - metabolism; Treatment Outcome; Urinary Bladder Neoplasms - complications; Urinary Bladder Neoplasms - surgery
• ISSN: 0278-0240; 1875-8630
• DOI: 10.1155/2020/8818445

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