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Preoperative determinant of early postoperative renal function following radical cystectomy and intestinal urinary diversion

  • Urology - Original Paper
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Abstract

Purpose

To identify preoperative factors correlated with postoperative early renal function in patients who had undergone radical cystectomy (RC) and intestinal urinary diversion.

Methods

We retrospectively identified 201 consecutive bladder cancer patients without distant metastasis who had undergone RC at our institution between 2003 and 2012. The estimated glomerular filtration rate (eGFR) was calculated using the modified Chronic Kidney Disease Epidemiology equation before RC and 3 months following RC. Univariate and stepwise multiple linear regression analyses were applied to estimate postoperative renal function and to identify significant preoperative predictors of postoperative renal function.

Results

Patients who had undergone intestinal urinary diversion and were available for the collection of follow-up data (n = 164) were eligible for the present study. Median preoperative and postoperative eGFRs were 69.7 (interquartile range [IQR] 56.3–78.0) and 70.7 (IQR 57.3–78.1), respectively. In univariate analyses, age, preoperative proteinuria, thickness of abdominal subcutaneous fat tissue (TSF), preoperative serum creatinine level, preoperative eGFR, and urinary diversion type were significantly associated with postoperative eGFR. In a stepwise multiple linear regression analysis, preoperative eGFR, age, and TSF were significant factors for predicting postoperative eGFR (p < 0.001, p = 0.02, and p = 0.046, respectively). The estimated postoperative eGFRs correlated well with the actual postoperative eGFRs (r = 0.65, p < 0.001).

Conclusions

Preoperative eGFR, age, and TSF were independent preoperative factors for determining postoperative renal function in patients who had undergone RC and intestinal urinary diversion. These results may be used for patient counseling before surgery, including the planning of perioperative chemotherapy administration.

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Authors and Affiliations

  1. Department of Urology, Tokyo Medical University, Tokyo, Japan

    Tatsuo Gondo, Yoshio Ohno, Jun Nakashima, Takeshi Hashimoto, Yoshihiro Nakagami & Masaaki Tachibana

  2. Department of Urology, Sanno Hospital, Tokyo, Japan

    Jun Nakashima

  3. Clinical Medicine Research Center, International University of Health and Welfare, Tokyo, Japan

    Jun Nakashima

Authors
  1. Tatsuo Gondo
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  2. Yoshio Ohno
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  3. Jun Nakashima
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  4. Takeshi Hashimoto
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  5. Yoshihiro Nakagami
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  6. Masaaki Tachibana
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Corresponding author

Correspondence to Tatsuo Gondo.

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Conflict of interest

All authors have no conflicts of interest with any institution or product.

Informed consent

The institutional review board approved this retrospective study and issued a waiver of informed consent. IRB approved protocol number is 1621.

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Gondo, T., Ohno, Y., Nakashima, J. et al. Preoperative determinant of early postoperative renal function following radical cystectomy and intestinal urinary diversion. Int Urol Nephrol 49, 233–238 (2017). https://doi.org/10.1007/s11255-016-1462-1

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  • DOI: https://doi.org/10.1007/s11255-016-1462-1

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