PD41-04 LONG-TERM RENAL FUNCTION OUTCOMES AFTER RADICAL CYSTECTOMY WITH ORTHOTOPIC NEOBLADDER IN PATIENTS WITH CHRONIC KIDNEY DISEASE

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You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion II (PD41)1 Apr 2020PD41-04 LONG-TERM RENAL FUNCTION OUTCOMES AFTER RADICAL CYSTECTOMY WITH ORTHOTOPIC NEOBLADDER IN PATIENTS WITH CHRONIC KIDNEY DISEASE Seyedeh-Sanam Ladi Seyedian*, Hamed Ahmadi, Alireza Ghoreifi, Sidney Roberts, Saum Ghodoussipour, Sumeet Bhanvadia, Hooman Djaladat, Anne Schuckman, and Siamak Daneshmand Seyedeh-Sanam Ladi Seyedian*Seyedeh-Sanam Ladi Seyedian* More articles by this author , Hamed AhmadiHamed Ahmadi More articles by this author , Alireza GhoreifiAlireza Ghoreifi More articles by this author , Sidney RobertsSidney Roberts More articles by this author , Saum GhodoussipourSaum Ghodoussipour More articles by this author , Sumeet BhanvadiaSumeet Bhanvadia More articles by this author , Hooman DjaladatHooman Djaladat More articles by this author , Anne SchuckmanAnne Schuckman More articles by this author , and Siamak DaneshmandSiamak Daneshmand More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000921.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Orthotopic neobladder (ONB) reconstruction following radical cystectomy (RC) is generally discouraged in patients with chronic kidney disease (CKD) as it is believed that it would cause significant electrolyte disturbances and worsening renal function in the long run. This study aims to evaluate long-term renal function outcomes of bladder cancer patients with CKD who received ONB. METHODS: According to our institutional IRB approved cystectomy database from January 2003 to December 2018, 2182 patients underwent RC for bladder cancer. ONB was constructed in 1280 (59%) patients of whom 273 had preoperative glomerular filtration rate (GFR) between 45 to 60 ml per minute/1.73 m2. Sixteen patients were excluded due to lack of follow up. Renal function was recorded at various time points postoperatively. A decrease in GFR > 10 ml per minute/1.73 m2 was considered as significant GFR drop. A multivariate cox regression analysis was performed to identify predictors of significant GFR drop. RESULTS: A total of 257 patients with complete follow up were included in this study (Table 1). Median follow-up was 2 years (IQR 7 months, 5 years). Mean preoperative GFR was 53.3 ± 4.2 ml per minute/1.73 m2. At 10-year mark follow up, 132 (51.3%) patients did not have any significant GFR drop (Figure 1). GFR also remained above 45 ml per minute/1.73 m2 in 125 (49%) patients. The median time to significant GFR drop was 1 year. On multivariate analysis, risk factors associated with significant GFR drop were age (HR 1.3, 95%CI: 1.3-5; P <0.006), neoadjuvant chemotherapy (HR 1.83, 95%CI: 1.2-2.7; P= 0.002), diabetes (HR 1.6, 95%CI: 1-2.6, P=0.02) and any complication within 30 days post-operatively (HR 1.47, 95%CI: 1-2.1, P=0.04). CONCLUSIONS: A significant proportion of patients with CKD and ONB seems to have a stable long term renal function and their baseline GFR does not seem to affect their long term renal function outcome. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e822-e822 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Seyedeh-Sanam Ladi Seyedian* More articles by this author Hamed Ahmadi More articles by this author Alireza Ghoreifi More articles by this author Sidney Roberts More articles by this author Saum Ghodoussipour More articles by this author Sumeet Bhanvadia More articles by this author Hooman Djaladat More articles by this author Anne Schuckman More articles by this author Siamak Daneshmand More articles by this author Expand All Advertisement PDF downloadLoading ...