Short- and Long-Term Evaluation of Renal Function after Radical Cystectomy and Cutaneous Ureterostomy in High-Risk Patients
Deterioration of renal function has been reported after radical cystectomy (RC) with urinary diversion. We investigated renal function changes in elderly bladder cancer (BCa) patients who underwent RC with cutaneous ureterostomy (CU) urinary diversion. We performed a retrospective, observational stu...
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| Veröffentlicht in: | Journal of clinical medicine 2020-07, Vol.9 (7), p.2191 |
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| creator | Creta, Massimiliano Fusco, Ferdinando La Rocca, Roberto Capece, Marco Celentano, Giuseppe Imbimbo, Ciro Imperatore, Vittorio Russo, Luigi Mangiapia, Francesco Mirone, Vincenzo Russo, Domenico Longo, Nicola |
| description | Deterioration of renal function has been reported after radical cystectomy (RC) with urinary diversion. We investigated renal function changes in elderly bladder cancer (BCa) patients who underwent RC with cutaneous ureterostomy (CU) urinary diversion. We performed a retrospective, observational study. BCa patients aged ≥75 with an American Society of Anesthesiologists (ASA) class greater than II were included. Glomerular filtration rate (GFR) was the main outcome measure. GFR values were recorded preoperatively, at discharge, at 6-month follow-up, and yearly up to 60 months. A total of 70 patients with a median age of 78.0 years were identified. Median preoperative GFR was 74.3 mL/min/1.73 m
and declined significantly to 54.6 mL/min/1.73 m
after 6 months (
< 0.001). A gradual GFR decline was observed thereafter, reaching a median value of 46.2 after 60 months. Preoperative GFR and acute kidney injury were significant predictors of fast deterioration of GFR and of 25% deterioration of GFR after 12 months. Elderly BCa patients with high comorbidity rates undergoing RC with CU should be carefully informed about the risk of GFR deterioration and the need for adequate monitoring. |
| doi_str_mv | 10.3390/jcm9072191 |
| format | Article |
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and declined significantly to 54.6 mL/min/1.73 m
after 6 months (
< 0.001). A gradual GFR decline was observed thereafter, reaching a median value of 46.2 after 60 months. Preoperative GFR and acute kidney injury were significant predictors of fast deterioration of GFR and of 25% deterioration of GFR after 12 months. Elderly BCa patients with high comorbidity rates undergoing RC with CU should be carefully informed about the risk of GFR deterioration and the need for adequate monitoring.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm9072191</identifier><identifier>PMID: 32664517</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Age ; Bladder cancer ; Blood pressure ; Body mass index ; Chemotherapy ; Clinical medicine ; Comorbidity ; Creatinine ; Diabetes ; Hydronephrosis ; Hypertension ; Mortality ; Ostomy ; Patients ; Regression analysis ; Surgery ; Urogenital system</subject><ispartof>Journal of clinical medicine, 2020-07, Vol.9 (7), p.2191</ispartof><rights>2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 by the authors. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c406t-ce75fcc23d42b6dba5b075ec614db44a37db087b63f9cd7eba68791de1210ed43</citedby><cites>FETCH-LOGICAL-c406t-ce75fcc23d42b6dba5b075ec614db44a37db087b63f9cd7eba68791de1210ed43</cites><orcidid>0000-0002-1951-404X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408808/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408808/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32664517$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Creta, Massimiliano</creatorcontrib><creatorcontrib>Fusco, Ferdinando</creatorcontrib><creatorcontrib>La Rocca, Roberto</creatorcontrib><creatorcontrib>Capece, Marco</creatorcontrib><creatorcontrib>Celentano, Giuseppe</creatorcontrib><creatorcontrib>Imbimbo, Ciro</creatorcontrib><creatorcontrib>Imperatore, Vittorio</creatorcontrib><creatorcontrib>Russo, Luigi</creatorcontrib><creatorcontrib>Mangiapia, Francesco</creatorcontrib><creatorcontrib>Mirone, Vincenzo</creatorcontrib><creatorcontrib>Russo, Domenico</creatorcontrib><creatorcontrib>Longo, Nicola</creatorcontrib><title>Short- and Long-Term Evaluation of Renal Function after Radical Cystectomy and Cutaneous Ureterostomy in High-Risk Patients</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>Deterioration of renal function has been reported after radical cystectomy (RC) with urinary diversion. We investigated renal function changes in elderly bladder cancer (BCa) patients who underwent RC with cutaneous ureterostomy (CU) urinary diversion. We performed a retrospective, observational study. BCa patients aged ≥75 with an American Society of Anesthesiologists (ASA) class greater than II were included. Glomerular filtration rate (GFR) was the main outcome measure. GFR values were recorded preoperatively, at discharge, at 6-month follow-up, and yearly up to 60 months. A total of 70 patients with a median age of 78.0 years were identified. Median preoperative GFR was 74.3 mL/min/1.73 m
and declined significantly to 54.6 mL/min/1.73 m
after 6 months (
< 0.001). A gradual GFR decline was observed thereafter, reaching a median value of 46.2 after 60 months. Preoperative GFR and acute kidney injury were significant predictors of fast deterioration of GFR and of 25% deterioration of GFR after 12 months. Elderly BCa patients with high comorbidity rates undergoing RC with CU should be carefully informed about the risk of GFR deterioration and the need for adequate monitoring.</description><subject>Age</subject><subject>Bladder cancer</subject><subject>Blood pressure</subject><subject>Body mass index</subject><subject>Chemotherapy</subject><subject>Clinical medicine</subject><subject>Comorbidity</subject><subject>Creatinine</subject><subject>Diabetes</subject><subject>Hydronephrosis</subject><subject>Hypertension</subject><subject>Mortality</subject><subject>Ostomy</subject><subject>Patients</subject><subject>Regression analysis</subject><subject>Surgery</subject><subject>Urogenital system</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkV1LHDEUhkOpVFFv_AES6E0RRvO1ycxNoSx-wYKy6nXIJJndrDOJTTLC0j_fuKvWmpuEcx7ec_K-ABxhdEppg85WemiQILjBX8AeQUJUiNb064f3LjhMaYXKqWtGsPgGdinhnE2w2AN_7pYh5goqb-As-EV1b-MAz59VP6rsgoehg3PrVQ8vRq83FdVlG-FcGadLebpO2eochvVGYzpm5W0YE3yItnAhbVrOwyu3WFZzlx7hbVG2PqcDsNOpPtnD13sfPFyc30-vqtnN5fX016zSDPFcaSsmndaEGkZablo1aZGYWM0xMy1jigrTolq0nHaNNsK2iteiwcZigpE1jO6Dn1vdp7EdrNFldlS9fIpuUHEtg3Ly_453S7kIz1KwYhmqi8CPV4EYfo82ZTm4pG3fb78qCSMMNZwTUdDvn9BVGGPxr1CcYcQpEy-CJ1tKF4NStN37MhjJl1jlv1gLfPxx_Xf0LUT6F1y3n6M</recordid><startdate>20200711</startdate><enddate>20200711</enddate><creator>Creta, Massimiliano</creator><creator>Fusco, Ferdinando</creator><creator>La Rocca, Roberto</creator><creator>Capece, Marco</creator><creator>Celentano, Giuseppe</creator><creator>Imbimbo, Ciro</creator><creator>Imperatore, Vittorio</creator><creator>Russo, Luigi</creator><creator>Mangiapia, Francesco</creator><creator>Mirone, Vincenzo</creator><creator>Russo, Domenico</creator><creator>Longo, Nicola</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1951-404X</orcidid></search><sort><creationdate>20200711</creationdate><title>Short- and Long-Term Evaluation of Renal Function after Radical Cystectomy and Cutaneous Ureterostomy in High-Risk Patients</title><author>Creta, Massimiliano ; 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and declined significantly to 54.6 mL/min/1.73 m
after 6 months (
< 0.001). A gradual GFR decline was observed thereafter, reaching a median value of 46.2 after 60 months. Preoperative GFR and acute kidney injury were significant predictors of fast deterioration of GFR and of 25% deterioration of GFR after 12 months. Elderly BCa patients with high comorbidity rates undergoing RC with CU should be carefully informed about the risk of GFR deterioration and the need for adequate monitoring.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>32664517</pmid><doi>10.3390/jcm9072191</doi><orcidid>https://orcid.org/0000-0002-1951-404X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; PubMed Central |
| subjects | Age Bladder cancer Blood pressure Body mass index Chemotherapy Clinical medicine Comorbidity Creatinine Diabetes Hydronephrosis Hypertension Mortality Ostomy Patients Regression analysis Surgery Urogenital system |
| title | Short- and Long-Term Evaluation of Renal Function after Radical Cystectomy and Cutaneous Ureterostomy in High-Risk Patients |
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