Biphasic decline in renal function after radical cystectomy with urinary diversion

Area of Science:

• Nephrology
• Urology
• Oncology

Background:

• Radical cystectomy with urinary diversion is a treatment for bladder cancer.
• Assessing long-term renal function after this procedure is crucial.

Purpose of the Study:

• To evaluate short- and long-term renal function in patients post-radical cystectomy with urinary diversion.
• To identify risk factors associated with renal function deterioration.

Main Methods:

• Retrospective study of 91 patients who survived ≥3 years after radical cystectomy and urinary diversion.
• Calculated estimated glomerular filtration rate (eGFR) and assessed longitudinal changes.
• Defined renal function deterioration and used logistic regression to identify risk factors.

Main Results:

• Mean eGFR decreased from 65.1 to 58.9 mL/min/1.73 m² within the first year post-surgery.
• Renal function declined by ~1.0 mL/min/1.73 m² annually thereafter.
• Ureteroenteric stricture was linked to early deterioration (OR 4.22). Diabetes (OR 8.24) and pyelonephritis (OR 4.89) were associated with late decline.

Conclusions:

• Early and late renal function deterioration post-cystectomy have distinct risk factors.
• Ureteroenteric stricture is a risk for early decline.
• Diabetes and pyelonephritis are risks for gradual late decline.