Predictive Value Of ScvO₂ For Acute Kidney Injury After Robot-assisted Partial Nephrectomy In Elderly Patients

Objective:To investigate the predictive value of central venous oxygen saturation（ScvO₂）in elderly patients with acute kidney injury（AKI）after robot-assisted partial nephrectomy（RAPN）.Methods:78 elderly patients who underwent RAPN in the Department of Urology,the Third Medical Center of Chinese PLA General Hospital from February to September 2022were selected.AKI was diagnosed according to the International Nephropathy Improving global prognosis criteria,and the patients were divided into AKI group（n=22）and non-AKI group（n=56）according to whether AKI occurred after surgery.Blood gas analysis of venous blood were taken after central venous puncture（T0）,5 min after renal artery occlusion（T1）,5 min after renal artery opening（T2）,and after surgery（T3）.Hemoglobin（Hb）,arterial blood lactic acid（Lac）,arterial oxygen partial pressure（Pa O₂）,ScvO₂were recorded respectively.Oxygen uptake rate（O₂ER）were calculated.Receiver operating characteristic（ROC）curve was used to analyze the predictive value of ScvO₂for AKI in elderly patients after RAPN.Results:Compared with non-AKI group,FPG levels in AKI group were significantly increased at T1—T2（P<0.05）.Compared with T0,FPG level in two groups were obviously increased at T1—T3（P<0.01）.Compared with T1,the level of FPG in T3 was significantly higher in non-AKI group（P<0.01）.Compared with non-AKI group,ScvO₂in AKI group was significantly increased at T1—T2（P<0.01）,Lac level at T2 was significantly increased（P<0.05）.There was no significant difference in O₂ER between the two groups at each time point（P>0.05）.Compared with T0,O₂ER in T1—T3 was significantly decreased（P<0.01）,and ScvO₂in both groups was significantly increased（P<0.01）.Compared with T1,ScvO₂in the non-AKI group was significantly increased at T2—T3（P<0.05,P<0.01）.Compared with T2,ScvO₂in non-AKI group was significantly higher in T3（P<0.05）.Multiple-factor analysis showed that T1ScvO₂（OR=1.127,95%CI 1.006-1.263,P=0.039）was an independent risk factor for AKI after RAPN.ROC curve analysis showed that T1 ScvO₂had a sensitivity of 77.3%,specificity of 71.4%,truncation value of 81%,and area under the curve（AUC）of 0.761in predicting AKI after RAPN.Conclusion:The increase of ScvO₂ has certain predictive value for the occurrence of short-term AKI after RAPN.