The Effect of Preoperative Biological Age on Hemodynamics and Renal Function

The Effect of Preoperative Biological Age on Intraoperative Hemodynamics and Postoperative Renal Function

Background The aim of this study is to explore the potential value of preoperative biological age as a predictor of intraoperative hemodynamic changes and postoperative renal function injury.

Methods Collect data using medical record system and surgical anesthesia system, and gather patients who have undergone surgery. Calculate the preoperative biological age of the patient and analyze the correlation between preoperative biological age accelerated aging and intraoperative hemodynamics and postoperative renal function damage.

Study Overview

• Status: Completed
• Conditions: Acute Kidney Injury; Acute Kidney Disease; Intraoperative Hypotension; Post-induction Hypotension

Detailed Description

With the intensification of population aging, the number of patients undergoing surgical procedures has been increasing year by year. However, traditional age indicators cannot fully reflect the physiological condition and surgical risks of patients. In clinical practice, preoperative evaluation is usually based on the patient's actual age, but this method fails to fully consider individual biological differences. As a new evaluation indicator, biological age can more accurately reflect an individual's physiological status and health level by comprehensively considering multiple biomarkers. Therefore, biological age has gradually become one of the important parameters for predicting surgical risk. The stability of intraoperative hemodynamics is crucial for the prognosis of surgical patients. Research has shown that intraoperative blood pressure fluctuations, heart rate variability, and other hemodynamic abnormalities are closely related to the occurrence of postoperative complications. Postoperative renal dysfunction (AKI) is a common and serious postoperative complication, especially more common in elderly patients. Previous studies have found that the occurrence of AKI is not only related to intraoperative hemodynamic disorders, but also significantly influenced by the patient's underlying health status. However, current research on the impact of biological age on intraoperative hemodynamics and its relationship with postoperative renal function injury is still limited. Further exploration of the relationship between preoperative biological age and intraoperative hemodynamic parameters, as well as their predictive value for postoperative renal function injury, will help improve the accuracy of preoperative risk assessment, optimize intraoperative management strategies, and ultimately improve patients' postoperative prognosis. Therefore, this study aims to provide a new predictive tool for clinical practice and a basis for personalized surgical management by systematically evaluating the impact of biological age on intraoperative hemodynamics and postoperative renal function injury.

Based on hospital data, evaluate the hemodynamic fluctuations and incidence of postoperative renal function damage in patients of different biological ages undergoing high-risk surgery. The study aims to verify whether biological age can be independent of traditional clinical evaluation indicators, provide more accurate prediction of perioperative risks for patients, and provide scientific basis for individualized treatment decision-making.

• Study Type: Observational
• Enrollment (Actual): 268833

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patients undergoing surgery with complete anaesthetic records

Description

Inclusion Criteria:

• Surgical pateints

Exclusion Criteria:

• (1) Lacking valid demographic information; (2) Lacking valid biological age; (3) Lacking blood pressure records

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Biological age; PhenoAge and Klemera-Doubal method biological age (KDM-BA), were utilized. PhenoAge was calculated using the combination of chronological age and nine clinical biomarkers (albumin, SCr, glucose, C-reactive protein (CRP), lymphocyte percentage, mean cell volume (MCV), red blood cell distribution width (RDW), alkaline phosphatase, and white blood cell count (WBC)). KDM-BA was calculated by chronological age and nine clinical biomarkers (albumin, SCr, CRP, alkaline phosphatase, systolic blood pressure, blood urea nitrogen, forced expiratory volume in one second (FEV1), glycated haemoglobin, and total cholesterol).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The incidence ofn AKI	Pateints encompasses an escalation in SCr of 50% or more, an increment of at least 0.3 mg/dL within 48 hours, or the need for RRT including haemodialysis, peritoneal dialysis, continuous renal replacement therapy, and kidney transplant. It was based on the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines.	Within 7 days postoperative,
The incidence of AKD	AKD was defined by a surge in SCr by more than 50%, or the initiation of RRT such as haemodialysis, peritoneal dialysis or continuous RRT.	Within 8-90 days post-surgery
The incidence of IOH	IOH was defined as the presence of intraoperative epoque with MAP below 60 mmHg.	During intraoperative period
The incidence of PIH	PIH was defined as at least one measurement of SAP below 90 mmHg.	From induction of general anesthesia to 20 minutes post-induction.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The incidence of AKI 2+	AKI 2+ was identified as an elevation in SCr to a level at least twice that of the baseline measurement.	0-7 days post-surgery
Cumulative duration of IOH and PIH	Calculate the cumulative duration below the threshold value	During surgery
The cumulative AUC of IOH and PIH.	Total area under each threshold (areas under the curve (AUC) measured in mmHg*minutes).	During surgery

Collaborators and Investigators

• Sponsor: Nanjing First Hospital, Nanjing Medical University
• Investigators: Study Director: Yali Ge, MD, The First Affiliated Hospital with Nanjing Medical University

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2015
• Primary Completion (Actual): April 30, 2024
• Study Completion (Actual): July 30, 2024

Study Registration Dates

• First Submitted: July 15, 2025
• First Submitted That Met QC Criteria: July 15, 2025
• First Posted (Actual): July 23, 2025

Study Record Updates

• Last Update Posted (Actual): July 23, 2025
• Last Update Submitted That Met QC Criteria: July 15, 2025
• Last Verified: September 1, 2023

More Information

Terms related to this study

• Keywords: Biological age; Acute Kidney Injury; Intraoperative Hypotension; Acute kidney disease; Biological aging; post-induction hypotension
• Additional Relevant MeSH Terms: Urogenital Diseases; Vascular Diseases; Cardiovascular Diseases; Male Urogenital Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Renal Insufficiency; Acute Kidney Injury; Hypotension; Kidney Diseases
• Other Study ID Numbers: KY-20240924-09

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No