Renal function of bladder cancer patients after urinary diversion by ileal conduit in Rajavithi Hospital

Authors

  • Sittichon Suriyawongkul Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Chawawat Gosrisirikul Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Vorapot Choonhaklai Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Tanet Thaidumrong Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Somkiat Pumpaisanchai Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Nattapong Wongwattanasatien Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Sermsin Sindhubodee Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand
  • Matchima Huabkong Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand

DOI:

https://doi.org/10.52786/isu.a.20

Keywords:

Renal function, bladder cancer, urinary diversion, ileal conduit

Abstract

Objectives: Our objectives were to evaluate the long-term renal function after radical cystectomy (RC) and ileal conduit diversion (ICD) and to analyze year-by-year the estimated glomerular filtration rate (eGFR) and morphologic upper urinary tract changes.

Materials and Methods: We retrospectively identified 214 patients who had undergone RC and ICD from 2012 to 2018, with regular postoperative follow-up visits. The eGFR was calculated using the Modification of Diet in Renal Disease equation at baseline and during follow-up. A renal function decrease was defined as a greater than 10 mL/min/1.73 m2 reduction in the estimated glomerular filtration rate.

Results: The median follow-up period after RC was 24 months (range, 6-60 months). The median eGFR decreased from 64 mL/min/1.73 m2 (range, 9-125 mL/min/1.73 m2) to 61.5 mL/min/1.73 m2 (range, 8-125 mL/min/1.73 m2). A decline in renal function occurred during the first postoperative years (2.74 mL/ min/1.73 m2 and 3.95 mL/min/1.73 m2 in the first and second year, respectively), with a slight decrease in the subsequent years. The strongest predictor of an eGFR decline was CKD stage 1 or 2 (> 60 mL/min/1.73 m2). Urinary obstruction was diagnosed in 6 patients (2.8%). Among the patients who underwent prompt interventional treatment, we did not find any association with the eGFR decline.

Conclusion: Patients with urinary ICD have a lifelong risk of chronic kidney disease. Regular monitoring of renal function and the morphologic upper urinary tract will permit early diagnosis and treatment of modifiable factors, avoiding irreversible kidney damage.

References

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Additional Files

Published

2021-06-01

How to Cite

Suriyawongkul, S., Gosrisirikul, C., Choonhaklai, V., Thaidumrong, T., Pumpaisanchai, S., Wongwattanasatien, N., Sindhubodee, S., & Huabkong, M. (2021). Renal function of bladder cancer patients after urinary diversion by ileal conduit in Rajavithi Hospital. Insight Urology, 42(1), 34–39. https://doi.org/10.52786/isu.a.20

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Original article