Renal impairment caused by temporary loop ileostomy

Abstract

Creation of a temporary loop ileostomy is a standard surgical procedure. This study was undertaken to determine whether dehydration associated with the ileostomy causes renal impairment. The prospective data from 107 consecutive patients undergoing temporary loop ileostomy between 2004 and 2009 was evaluated. GFR was calculated at the time of hospital discharge after constructing the ileostomy and at the time of deciding to close the ileostomy. The average GFR at the time of discharge after constructing the ileostomy was a median of 92.50 (60.75-223.88); at the time of deciding to close the ileostomy, it was 75.25 (4-135.13) ml/min/1.73m(2) (p < 0.001). In 20 patients renal function decreased, with a GFR <60ml/min/1.73m(2) during the ileostomy period; in six of these 20 patients, the decrease was severe (GFR <30ml/min/1.73m(2)). Underlying diseases, reasons for constructing ileostomies, sex, and time interval to closure did not affect renal function. Patients in whom GFR was decreased at the time of deciding to close the ileostomy presented with significantly more closure-related surgical complications. Renal impairment is a well-known potential complication of loop ileostomy. To avoid this complication, close control and backup support is recommended in these patients.