# Evaluation of Chronic Kidney Disease Risk Factors after Radical Nephrectomy
## 3 Results
A longer IOH time and higher loss of blood during RN was found in AKI patients, 20.0 (0.0; 43.8) vs. 0.0 (0.0 to 17.5) min \(p\) = 0.024 and 282.5 (201.2; 530.0) vs. 220.0 (162.5; 275.0) mL \(p\) = 0.044, respectively. Moreover, we found that AKI patients had a higher NLR mean, 4.1 (3.1; 6.7) vs. 2.7 (2.3; 2.9), \(p\) < 0.001. The primary and postoperative eGFR means were lower in the CKD than in the non-CKD patients group, see Figure 3. All perioperative and postoperative laboratory data of CKD and non-CKD patients are summarized in Supplementary Table S1: CKD and non-CKD patients' perioperative and postoperative laboratory data. Table 2 demonstrates the CKD possible risk factors after RN. With each 1 mL estimated loss of blood (OR 1.01, 95% CI 1.00-1.02, \(p\) < 0.001) during RN, it was evaluated that a longer IOH was the main predictor of postoperative CKD with an OR of 1.09 (95% CI 1.02-1.17, \(p\) < 0.01). Having a higher eGFR and contralateral kidney CT volume before RN were related with a decreased risk of postoperative CKD; the ORs were 0.89 (95% CI 0.80-0.98) and 0.97 (95% CI 0.94-1.00) and \(p\)-values were 0.02 and 0.04, respectively. This multivariable analysis is presented in Figure 4.  
The ROC analysis with sensitivity 95.6% and specificity 95.7% of this logistic regression model is shown in Figure 5.  
[PERSON]'s test (Figure 6) revealed that non-AKI and AKI without CKD upstage have no impact on eGFR 1 year after RN except clinically significant AKI (effect size (g = \(-\)1.08), \(p\) < 0.001). Figure 3: Preoperative and postoperative eGFR changes after RN. Abbreviations: eGFR—estimated glomerular filtration rate; CKD—chronic kidney disease. \begin{table}
\begin{tabular}{c c c c c c c c} \hline \hline  & \multicolumn{6}{c}{**Univariate**} \\ \hline
**Parameters** & **Estimate** & **Non-CKD** & **CKD** & **OR** & **95\% CI** & _p-Value_1 ** \\ \hline Age & Mean (SD) & 56.1 (9.7) & 67.3 (9.6) & 1.12 & 1.07–1.18 & \textless{}0.001 \\ BMI & Mean (SD) & 31.1 (25.4) & 30.3 (5.3) & 1.00 & 0.97–1.02 & 0.825 \\ Comorbidities: & N (\%) & & & & & \\ No data & 32 (80.0) & 8 (20.0) & – & – & – \\ HTN & & 14 (30.4) & 32 (69.6) & 9.14 & 3.51–26.17 & \textless{}0.001 \\ HTN and DM & & 1 (14.3) & 6 (85.7) & 24.00 & 3.46–489.01 & 0.006 \\ CT nephrometry & Mean (SD) & 9.0 (1.1) & 9.8 (1.2) & 1.85 & 1.28–2.82 & 0.002 \\ No metabolic & Mean (SD) & 28 (68.3) & 13 (31.7) & 0.27 & 0.11–0.62 & 0.003 \\ Prooperative & & & & & & \\ eGFR & Mean (SD) & 92.6 (12.8) & 74.2 (12.2) & 0.89 & 0.84–0.93 & \textless{}0.001 \\ Estimated blood & & & & 480.7 & & & \\ loss & & & & & & \\ Intraoperative & & & & & & \\ hypotension & Mean (SD) & 6.9 (11.3) & 41.1 (24.0) & 1.11 & 1.07–1.16 & \textless{}0.001 \\ time & & & & & & \\ Contralateral & & & & & & \\ kidney CT & Mean (SD) & 289.4 (85.7) & 190.1 (42.1) & 0.96 & 0.94–0.98 & \textless{}0.001 \\ volume & & & & & & \\ NLR & Mean (SD) & 3.8 (2.2) & 5.7 (3.3) & 1.34 & 1.12–1.66 & 0.004 \\ \hline \hline \end{tabular} \(p\)-value describes the mathematical relationship between each independent variable and the dependent variable CKD. 1 Mann–Whitney U test; [PERSON]’s Chi-squared test; [PERSON]’s exact test. Abbreviations: BMI—body mass index; DM—diabetes mellitus; HTN—hypertension; CKD—chronic kidney disease; OR—odds ratio; CT—computed tomography; CI—confidence interval; eGFR—estimated glomerular filtration rate, NLR—neutrophilato-lymphocyte ratio.  
\end{table} 
Table 2: Clinical characteristics of CKD potential predictors in the univariate analysis. Figure 4: Risk factors of CKD 12 months after radical nephrectomy. Abbreviations: CT—computed tomography; eGFR—estimated glomerular filtration rate. Figure 5: ROC analysis of predicting CKD after radical nephrectomy. Abbreviations: AUC—area under the curve. Figure 6: The effect of postoperative clinically significant AKI on eGFR 12 months after RN. Abbreviations: CKD—chronic kidney disease; eGFR—estimated glomerular filtration rate; AKI—acute kidney injury.