WCE 2019: The Impact of Postoperative AKI after Robotic PN on Patient Outcomes and Predictors to Ascertain Risk

Abu Dhabi, United Arab Emirates (UroToday.com) Dr. Alexander Small began by stating that acute kidney injury (AKI), in the previous series, have been identified in up to 10% of patients and it is associated with progression to chronic kidney failure, increased hospital stay, increased complications, and increased mortality. The goal of the study Dr. Small presented, was to examine the prevalence and impact of postoperative AKI on patient outcomes after robotic-assisted partial nephrectomy (RAPN). Dr. Small also wanted to determine indicators of developing AKI in this cohort of patients.

Dr. Small utilized the New York Statewide Planning and Research Cooperative Systems (SPARCS) database. SPARCS is a comprehensive all-payer data reporting system that collects patient-level detail on patient characteristics, diagnosis, treatment, services, and charges for each hospital in New York. Dr. Small and his team identified all patients in the database who underwent RAPN between 2008 and 2015.

Dr. Small presented a total of 4411 patients who underwent RAPN. The rate of AKI in these patients was 1.5-3.6% per year. 124 patients (3%) had diagnosed postoperative AKI. As expected,  patients with AKI had longer lengths of stay, a higher proportion of 30-day readmissions, and increased mortality at 1 year.

Dr. Small concluded that the rate of AKI after RAPN in New York state was lower than previously reported national average (3% vs 10%). As a future study, it would be interesting to expand the SPARCS database to a national database such as the National Cancer Database (NCDB).

Presented by: Alexander Small, MD, Urologist, Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY

Written by: Lillian Xie, BA, Department of Urology, University of California, Irvine, California at the 37th World Congress of Endourology (WCE) – October 29th-November 2nd, Abu Dhabi, United Arab Emirates