MP56-01 RENAL FUNCTIONAL CHANGES AFTER CYSTECTOMY: WHO IMPROVES AND WHO DOES NOT?

Abstract

You have accessJournal of UrologyCME1 May 2022MP56-01 RENAL FUNCTIONAL CHANGES AFTER CYSTECTOMY: WHO IMPROVES AND WHO DOES NOT? Benjamin Croll, Dattatraya Patil, Khushali Vashi, Mehrdad Alemozaffar, Viraj Master, Christopher Filson, Kenneth Ogan, Vikram Narayan, and Shreyas Joshi Benjamin CrollBenjamin Croll More articles by this author , Dattatraya PatilDattatraya Patil More articles by this author , Khushali VashiKhushali Vashi More articles by this author , Mehrdad AlemozaffarMehrdad Alemozaffar More articles by this author , Viraj MasterViraj Master More articles by this author , Christopher FilsonChristopher Filson More articles by this author , Kenneth OganKenneth Ogan More articles by this author , Vikram NarayanVikram Narayan More articles by this author , and Shreyas JoshiShreyas Joshi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002639.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A significant decline in renal function following radical cystectomy has been documented in numerous settings and with a variety of urinary diversions. Implications of poor post-operative renal function include the need for renal replacement therapy and exclusion from adjuvant therapies. In the present study, we seek to better characterize two groups of particular interest: those with pre-operative renal impairment (PORI) who improve post-operatively and those with normal renal function who subsequently develop chronic renal insufficiency after surgery. METHODS: A prospectively maintained, single-institutional database retrospectively identified 367 patients who underwent radical cystectomy between 2013 and 2021. Patients were stratified by the presence of PORI, defined as having Stage III CKD (CKD3) or worse (n=142, 38.7%). Variables included the presence of ureteral obstruction before surgery and within one year post-operatively, diabetes, neoadjuvant chemotherapy, age, and rates of major complications. RESULTS: Compared to those with PORI, those with better renal function had a lower incidence of diabetes (33.1% vs. 20.4%, p=0.007). Rates of major complications after cystectomy were not significantly different between those with PORI vs. normal renal function (15.5% vs. 13.8%, p=0.649). Of those with PORI, 21 (23.3%) experienced renal function improvement to GFR >59 mL/min/1.73 m2 at 12 months post-operatively. Of these improved patients, 12 (57.1%) initially presented with ureteral obstruction. Within the remaining 225 patients without PORI, 49 patients (36.3%) developed CKD3 at 12 months post-operatively. Among these patients with renal function decline, 16 (32.7%) had ureteral obstruction within one year after surgery. Presence of diabetes, age >70, history of neoadjuvant chemotherapy, and type of diversion were not significantly different between the above groups. CONCLUSIONS: While 36.3% of patients with normal pre-operative renal function experienced a decline to CKD3 at one year, 23.3% of patients with PORI had resolution of CKD3 at one year. Ureteral obstruction appears to play a significant role in changes in long-term renal function. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e971 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benjamin Croll More articles by this author Dattatraya Patil More articles by this author Khushali Vashi More articles by this author Mehrdad Alemozaffar More articles by this author Viraj Master More articles by this author Christopher Filson More articles by this author Kenneth Ogan More articles by this author Vikram Narayan More articles by this author Shreyas Joshi More articles by this author Expand All Advertisement PDF DownloadLoading ...