title: Long-term renal function outcomes in bladder cancer after radical cystectomy.
abstract: OBJECTIVE
  To evaluate postoperative renal function and risk factors for the loss of renal function in patients who had undergone radical cystectomy.
  
  
  METHODS
  A retrospective single institutional study evaluated 70 patients, including 54 men and 16 women who underwent radical cystectomy. The median follow-up period was 34.5 months (range, 12 to 228 months). In this cohort, four types of urinary diversions were studied, including ileal neobladder (n = 24), ileocecal neobladder (n = 12), ileal conduit (n = 25), and cutaneous ureterostomy (n = 9). Postoperative changes in renal function were reviewed, and the estimated serum creatinine-based glomerular filtration rate (eGFR) was calculated. The variables analyzed were age, a prior history of hypertension or diabetes mellitus, pre-operative renal function, type of urinary diversion, the postoperative occurrence of acute pyelonephritis, and the presence of chemotherapy.
  
  
  RESULTS
  The mean eGFR was 74.6 (range, 15.2 to 155.1) mL/min/1.73 m² before surgery and 63.6 (range, 8.7 to 111.5) mL/min/1.73 m² at the last follow-up. The 10-year renal deterioration-free interval was 63.8%. Multivariate analysis showed that a postoperative episode of acute pyelonephritis [Odds Ratio (OR), 3.21; 95% Confidence Interval (CI), 1.14 to 9.02; P = .03] and the presence of chemotherapy (OR, 3.27; 95% CI, 1.33 to 8.01; P = .01) were significant adverse factors.
  
  
  CONCLUSIONS
  Twenty-four (34.2%) patients demonstrated reduced renal function during the follow-up period. Postoperative episodes of acute pyelonephritis and the presence of chemotherapy were found to be significant adverse factors.
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. taka0573@gmail.com
authors.forename: Takahiro
authors.initials: T
authors.lastname: Osawa
authors.forename: Nobuo
authors.initials: N
authors.lastname: Shinohara
authors.forename: Satoru
authors.initials: S
authors.lastname: Maruyama
authors.forename: Koji
authors.initials: K
authors.lastname: Oba
authors.forename: Takashige
authors.initials: T
authors.lastname: Abe
authors.forename: Shintaro
authors.initials: S
authors.lastname: Maru
authors.forename: Norikata
authors.initials: N
authors.lastname: Takada
authors.forename: Ataru
authors.initials: A
authors.lastname: Sazawa
authors.forename: Katsuya
authors.initials: K
authors.lastname: Nonomura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000601:surgery*