Novel Biomarkers and Postoperative Kidney Injury in Radical Nephrectomy

NCT07088874 | Recruiting

• 1 other identifier: 2025-067
• Study Type: observational
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

The incidence of acute kidney injury (AKI) after radical nephrectomy exceeds 40%. Currently, the KDIGO criteria are the recognized diagnostic standard for AKI. These criteria primarily use serum creatinine and urine output as key indicators, but both parameters have certain limitations, such as delayed response, insensitivity, and inaccuracy. This study aims to simultaneously monitor perioperative novel renal damaging, stressful, and functional biomarkers in patients undergoing radical nephrectomy, and to investigate their predictive value for AKI and postoperative 1-year chronic kidney disease (CKD).

Conditions

Nephrectomy; Acute Kidney Injury; Biomarker

Outcome Measures

Primary Outcomes (1)

• The urinary [TIMP-2]×[IGFBP-7], urinary NGAL, urinary KIM-1, serum cystatin C and their combinations to predict postoperative AKI occurring within 7 days.

  Novel biomarkers above were collected at the end of surgery, and at postoperative 1h, 6h, and 20h. AKI diagnosed according to 2012 KDIGO criteria (occurring within 7 days after surgery).

  Up to 7 days after surgery.

Secondary Outcomes (3)

• The urinary [TIMP-2]×[IGFBP-7], urinary NGAL, urinary KIM-1, serum cystatin C and their combinations to predict new onset/worsening CKD occurring within 1 year after surgery.

  Up to 1 year after surgery

• The urinary [TIMP-2]×[IGFBP-7], urinary NGAL, urinary KIM-1, serum cystatin C combined with clinically important risk factors to predict postoperative AKI occurring within 7 days after surgery.

  Up to 7 days after surgery.

• The postoperative urinary [TIMP-2]×[IGFBP-7], urinary NGAL, urinary KIM-1, serum cystatin C combined with clinically important risk factors to predict postoperative the new onset/worsening CKD occurring within 1 year after surgery.

  Up to 1 year after surgery.

Study Arms (2)

AKI group/CKD group

1. patients diagnosed with AKI after radical nephrectomy. 2. patients diagnosed with the new onset/worsening of CKD after radical nephrectomy.

non-AKI group/non-CKD group

1. patients without AKI after radical nephrectomy. 2. patients without new onset/worsening of CKD after radical nephrectomy.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Targeting patients undergoing radical nephrectomy for renal cell carcinoma

You may qualify if:

• Age ≥18 years;
• Scheduled to undergo unilateral radical nephrectomy.

You may not qualify if:

• Solitary kidney;
• Preoperative diagnosis of chronic kidney disease stages G4 or G5 (GFR \<30 mL/min/1.73m²);
• Tumor invasion of the vena cava requiring thrombectomy;
• Other conditions deemed by the investigator as unsuitable for participation in this study.

Sponsors & Collaborators

• Peking University First Hospital: lead

Study Sites (1)

Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital

Beijing, Beijing Municipality, 100034, China

RECRUITING

Related Publications (8)

• Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179-84. doi: 10.1159/000339789. Epub 2012 Aug 7. No abstract available.

  PMID: 22890468 BACKGROUND

• Antonelli A, Allinovi M, Cocci A, Russo GI, Schiavina R, Rocco B, Giovannalberto P, Celia A, Galfano A, Varca V, Bozzini G, Ceruti C, Greco F, Verze P, Pastore AL, Porreca A, Minervini A; AGILE Group. The Predictive Role of Biomarkers for the Detection of Acute Kidney Injury After Partial or Radical Nephrectomy: A Systematic Review of the Literature. Eur Urol Focus. 2020 Mar 15;6(2):344-353. doi: 10.1016/j.euf.2018.09.020. Epub 2018 Oct 9.

  PMID: 30309817 BACKGROUND

• Rossiter A, La A, Koyner JL, Forni LG. New biomarkers in acute kidney injury. Crit Rev Clin Lab Sci. 2024 Jan;61(1):23-44. doi: 10.1080/10408363.2023.2242481. Epub 2023 Sep 5.

  PMID: 37668397 BACKGROUND

• Ostermann M, Zarbock A, Goldstein S, Kashani K, Macedo E, Murugan R, Bell M, Forni L, Guzzi L, Joannidis M, Kane-Gill SL, Legrand M, Mehta R, Murray PT, Pickkers P, Plebani M, Prowle J, Ricci Z, Rimmele T, Rosner M, Shaw AD, Kellum JA, Ronco C. Recommendations on Acute Kidney Injury Biomarkers From the Acute Disease Quality Initiative Consensus Conference: A Consensus Statement. JAMA Netw Open. 2020 Oct 1;3(10):e2019209. doi: 10.1001/jamanetworkopen.2020.19209.

  PMID: 33021646 BACKGROUND

• Gocze I, Jauch D, Gotz M, Kennedy P, Jung B, Zeman F, Gnewuch C, Graf BM, Gnann W, Banas B, Bein T, Schlitt HJ, Bergler T. Biomarker-guided Intervention to Prevent Acute Kidney Injury After Major Surgery: The Prospective Randomized BigpAK Study. Ann Surg. 2018 Jun;267(6):1013-1020. doi: 10.1097/SLA.0000000000002485.

  PMID: 28857811 BACKGROUND

• Kane-Gill SL, Peerapornratana S, Wong A, Murugan R, Groetzinger LM, Kim C, Smithburger PL, Then J, Kellum JA. Use of tissue inhibitor of metalloproteinase 2 and insulin-like growth factor binding protein 7 [TIMP2]*[IGFBP7] as an AKI risk screening tool to manage patients in the real-world setting. J Crit Care. 2020 Jun;57:97-101. doi: 10.1016/j.jcrc.2020.02.002. Epub 2020 Feb 4.

  PMID: 32086072 BACKGROUND

• Leem AY, Park MS, Park BH, Jung WJ, Chung KS, Kim SY, Kim EY, Jung JY, Kang YA, Kim YS, Kim SK, Chang J, Song JH. Value of Serum Cystatin C Measurement in the Diagnosis of Sepsis-Induced Kidney Injury and Prediction of Renal Function Recovery. Yonsei Med J. 2017 May;58(3):604-612. doi: 10.3349/ymj.2017.58.3.604.

  PMID: 28332367 BACKGROUND

• Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024 Apr;105(4S):S117-S314. doi: 10.1016/j.kint.2023.10.018. No abstract available.

  PMID: 38490803 BACKGROUND

Biospecimen

Retention: SAMPLES WITHOUT DNA

perioperative AKI damaging (such as NGAL), stressful (such as TIMP-2, IGFBP-7) and functional novel (cystatin C) biomarkers and serum creatinine

MeSH Terms

Conditions

Acute Kidney Injury

Condition Hierarchy (Ancestors)

Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases

Central Study Contacts

Qiongfang Wu, MD

CONTACT

8610 83572460; wuqf91@163.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Year
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Peking University First Hospital

Study Record Dates

• First Submitted: July 10, 2025
• First Posted: July 28, 2025
• Study Start: August 2, 2025
• Primary Completion (Estimated): July 30, 2026
• Study Completion (Estimated): July 30, 2027
• Last Updated: September 8, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)