Annals of Surgical Oncology

, Volume 23, Issue 2, pp 686–693 | Cite as

Acute Kidney Injury After Radical Cystectomy for Bladder Cancer is Associated with Chronic Kidney Disease and Mortality

  • Taekmin Kwon
  • In Gab Jeong
  • Chunwoo Lee
  • Dalsan You
  • Bumsik Hong
  • Jun Hyuk Hong
  • Hanjong Ahn
  • Choung-Soo KimEmail author
Urologic Oncology



The aim of this study was to investigate the prevalence of acute kidney injury (AKI) after radical cystectomy, and evaluate its impact on chronic kidney disease (CKD) and mortality.


The medical records of 866 patients who underwent radical cystectomy for bladder cancer were reviewed. AKI was assessed within 7 days after surgery according to the Acute Kidney Injury Network criteria. The prevalence of AKI after surgery was examined, and the significance of AKI for CKD and mortality was analyzed.


Of 866 patients, 269 (31.1 %) developed AKI in the first week after surgery. Of these, 231 (85.9 %) were at stage 1, 32 (11.9 %) at stage 2, and 6 (2.2 %) at stage 3. Of 722 patients with a preoperative Modification of Diet in Renal Disease estimated glomerular filtration rate (eGFR) of >60 ml/min/1.73 m2, CKD developed in 23.0 % (118/513) of patients in the non-AKI group and 32.5 % (68/209) of patients in the AKI group. Independent factors predicting new-onset CKD were a preoperative eGFR (p < 0.001), age (p = 0.011), urinary tract complication (p < 0.001) and AKI (p = 0.015). In all, 297 patients died (191 in the non-AKI group and 106 in the AKI group). AKI also correlated significantly with overall survival (p = 0.001).


AKI is not only commonly encountered after radical cystectomy but is also associated with higher CKD rates and mortality. There is a critical need for strategies to increase the identification of patients at risk of postoperative AKI, and to improve the management of patients, with an aim toward preventing AKI and improving the treatment of AKI once it occurs.


Overall Survival Chronic Kidney Disease Acute Kidney Injury Radical Cystectomy Urinary Diversion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Taekmin Kwon, In Gab Jeong, Chunwoo Lee, Dalsan You, Bumsik Hong, Jun Hyuk Hong, Hanjong Ahn, and Choung-Soo Kim have no conflicts of interest or financial disclosures.


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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Taekmin Kwon
    • 1
    • 2
  • In Gab Jeong
    • 2
  • Chunwoo Lee
    • 2
  • Dalsan You
    • 2
  • Bumsik Hong
    • 2
  • Jun Hyuk Hong
    • 2
  • Hanjong Ahn
    • 2
  • Choung-Soo Kim
    • 2
    Email author
  1. 1.Department of Urology, Ulsan University HospitalUniversity of Ulsan College of MedicineUlsanKorea
  2. 2.Department of Urology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea

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