While dyslipidemia is well-documented as a factor in renal dysfunction, its specific rolein postoperative acute kidney injury (Post-AKI) following nephron-sparing surgery (NSS) remains poorly understood. This study aims to evaluate the predictive value of serum lipid parameters for Post-AKI in patients undergoing NSS

A retrospective analysis with 4,590 patients who underwent NSS between 2008 and 2021. After inclusion and exclusion criteria, 3,439 patients were included. The primary outcome was Post-AKI. A nomogram incorporating TG levels was developed and validated using ROC curves, calibration curves, and decision curve analysis across training and validation cohorts

This study identified several independent risk factors for postoperative Post-AKI in 3,439 patients undergoing NSS, including older age, male sex, higher BMI, larger tumor size, longer operative and warm ischemia times (WIT), elevated triglycerides (TG), and preoperative serum creatinine (Pre-Scr), among others. Multivariate analysis revealed that elevated TG levels were an independent predictor of Post-AKI (HR 1.281, 95% CI: 1.200–1.368, P<0.001). A predictive model incorporating these risk factors demonstrated high accuracy (AUC 0.815 in the training cohort, 0.803 in the validation cohort) and excellent precision (1.000 and 0.984 in training and validation cohorts). However, the study’s retrospective design introduces potential bias, and unaccounted factors such as intraoperative variables could affect the outcomes.

The authors demonstrate that TG levels independently predict Post-AKI in NSS, providing a means for early identification and prevention, which can enhance perioperative management and lower AKI rates