Role and diagnostic value of DKK3,Nrf2 and AOPP in acute kidney injury in patients with renal cancer after laparoscopic partial nephrectomy
LU Tefei
ZHANG Lei
LI Xing
Abstract：Objective To investigate the role and diagnostic value of serum Dickkopf-related protein 3(DKK3),plasma nuclear factor E2-related factor 2(Nrf2),and human advanced oxidation protein products(AOPP)in acute kidney injury(AKI)in patients with renal cancer after laparoscopic partial nephrectomy,so as to provide a reference basis for prevention and treatment of AKI in patients with renal cancer after laparoscopic partial nephrectomy.Methods A total of 196 patients with renal cancer who underwent laparoscopic partial nephrectomy in Ningbo Medical Center Li Huili Hospital from October 2021 to October 2024 were selected as the study subjects,and the selected patients were divided into AKI group(53 cases)and non-AKI group(143 cases)according to whether they developed AKI or not.The clinical data and serum DKK3,plasma Nrf2,and AOPP levels were compared between the two groups,and the risk factors for the occurrence of AKI in patients with renal cancer after laparoscopic partial nephrectomy were analyzed by multivariate logistic regression,and AKI group was taken as the positive group and non-AKI group was taken as the negative group.The diagnostic value of serum DKK3,plasma Nrf2,and AOPP for the occurrence of AKI in patients with renal cancer after laparoscopic partial nephrectomy was analyzed by plotting receiver operating characteristic(ROC)curve,and the area under the curve(AUC)was obtained.Results The proportion of body mass index(BMI)＞25 kg/m2,age＞65 years,comorbid diabetes,time of intraoperative renal artery occlusion＞25 min,and warm ischemia time＞25 min and the serum DKK3 and plasma AOPP levels were higher in the AKI group than those in the non-AKI group(P＜0.01),and the level of plasma Nrf2 was lower than that in the non-AKI group(P＜0.01).Multivariate logistic regression analysis showed that BMI＞25 kg/m2(OR=2.010,95％CI:1.363-2.963),age＞65 years(OR=2.063,95％CI:1.452-2.930),comorbid diabetes(OR=2.171,95％CI:1.513-3.113),time of intraoperative renal artery occlusion＞25 min(OR=2.492,95％CI:1.591-3.903),warm ischemia time＞25 min(OR=2.779,95％CI:1.699-4.545),high serum DKK3 level(OR=3.093,95％CI:1.851-5.168),and high plasma AOPP level(OR=2.593,95％CI:1.729-3.891),and low plasma Nrf2 level(OR=2.321,95％CI:1.523-3.537)were independent risk factors for AKI in patients with renal cancer after laparoscopic partial nephrectomy(P＜0.01).ROC analysis showed that serum DKK3,plasma Nrf2,and AOPP to diagnose the occurrence of AKI in patients with renal cancer after laparoscopic partial nephrectomy had an AUC value of 0.916,which was higher than that of each index alone(0.826,0.749,and 0.765,P＜0.01).Conclusion Serum DKK3 and plasma AOPP are highly expressed in AKI in patients with renal cancer after laparoscopic partial nephrectomy,while plasma Nrf2 is low,and the combined detection of serum DKK3,plasma AOPP,and plasma Nrf2 is more advantageous in the diagnosis of AKI in patients with renal cancer after laparoscopic partial nephrectomy.AKI in patients with renal cancer after laparoscopic partial nephrectomy is closely related to BMI＞25 kg/m2,age＞65 years,comorbid diabetes,time of intraoperative renal artery occlusion＞25 min,warm ischemia time＞25 min,high levels of serum DKK3,plasma AOPP and low level of plasma Nrf2.
Keywords：laparoscopic partial nephrectomyacute kidney injuryDickkopf-related protein 3nuclear factor E2-related factor 2human advanced oxidation protein productsdiagnostic value
Publication Date：2025-06-30
Online Publishing Date：2026-08-26(First online date of this platform, not the publication date of the document)
Pages：7( 804-810 )