Abstract
BackgroundChronic kidney disease (CKD) and end stage renal disease (ESRD) are not well characterized in prostate cancer patients. This study aimed to examine the clinical characteristics and postsurgical outcomes of patients with or without CKD and ESRD undergoing radical prostatectomy for prostate cancer.MethodsThis population-based, retrospective study used patient data from the Nationwide Inpatient Sample, the largest all-payer US inpatient care database. From 2005 to 2014, 136,790 male patients aged > 20 years diagnosed with prostate cancer and who received radical prostatectomy were included. Postoperative complications, postoperative acute kidney injury (AKI) and urinary complications, and length of hospital stay were compared between patients with or without underlying CKD and ESRD.ResultsAfter adjusting for relevant factors, the CKD group had a significantly higher risk of postoperative complications than the non-CKD group. In addition, the CKD group had a 5-times greater risk of postoperative AKI and urinary complications than the non-CKD group. Both CKD and ESRD groups had significantly longer hospital stays than the non-CKD group. Patients receiving RARP had a lower risk of postoperative complications than those who received open radical prostatectomy, regardless of having CKD or not. Both non-CKD and CKD patients receiving RARP had shorter hospital stays than those who received open surgery.ConclusionsProstate cancer patients with underlying CKD had significantly greater risk of postoperative complications, postoperative AKI and urinary complications, and longer hospital stays than those without CKD. The use of RARP significantly shortened hospital stays and reduced complications for these patients.
Highlights
Chronic kidney disease (CKD) and end stage renal disease (ESRD) are not well characterized in prostate cancer patients
After excluding 45 cases without data for postoperative mortality or Associations between clinical outcomes and kidney disease The results of regression analyses are presented in Table 3 and given in detail in Additional file 1: Table S1
The results showed that patients in the CKD and ESRD groups were at greater risk of postoperative complications than those in the non-CKD group (OR = 2.66 and 2.83, 95% CI = 2.36–3.00 and 2.14–3.75, respectively) (Table 3)
Summary
Chronic kidney disease (CKD) and end stage renal disease (ESRD) are not well characterized in prostate cancer patients. Hospitalized patients with AKI are at 8–9 times greater risk of developing chronic kidney disease (CKD) and 3 times greater risk of developing end-stage renal disease (ESRD) [1]. While Western CKD and ESRD patients are often older adults with diabetes and hypertension, those in developing countries are younger, and reduced kidney function is associated with infectious diseases (e.g., HIV/AIDS, malaria, leptospirosis), herbal medicines, obstetric complications, and exposure to environmental toxins [2]. The younger patients in developing countries have much lower access to treatment; one study found that only 5% of ESRD patients in China, India, and Nigeria have access to RRT [4]
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