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Cobalamin profiles in patients after urinary diversion
Arthur I Sagalowsky1, Eugene P Frenkel
1Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
The Journal of Urology
|March 26, 2002
Summary
Urinary diversion increases the risk of vitamin B12 deficiency. Comprehensive testing reveals higher rates of tissue cobalamin deficiency than previously thought, necessitating monitoring or supplementation.
Area of Science:
- Urology
- Biochemistry
- Nutritional Science
Background:
- Urinary diversion procedures are common in urological practice.
- Cobalamin (vitamin B12) deficiency can lead to serious neurological and hematological complications.
- Previous assessments may have underestimated the risk of deficiency after urinary diversion.
Purpose of the Study:
- To evaluate the incidence of tissue cobalamin deficiency in patients undergoing various urinary diversion techniques.
- To compare the diagnostic utility of complete cobalamin profiles versus serum vitamin B12 levels alone.
Main Methods:
- A cohort of 41 patients with different types of urinary diversion (ileal neobladder, ileal reservoir, ileocecal reservoir, ileal conduit) were studied.
- Serum vitamin B12, methylmalonic acid, and homocysteine levels were measured.
- Follow-up ranged from 0 to 10 years.
Main Results:
- Complete cobalamin profiles indicated a higher prevalence of tissue cobalamin deficiency across all urinary diversion types compared to serum vitamin B12 measurements alone.
- This suggests that serum vitamin B12 levels may not fully capture the extent of cobalamin depletion.
Conclusions:
- The risk of chronic tissue cobalamin deficiency following urinary diversion is significantly underestimated when relying solely on serum vitamin B12 measurements.
- Long-term monitoring for cobalamin deficiency or proactive supplemental therapy is crucial to prevent irreversible clinical sequelae in these patients.