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

Abstract EN

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.