title: Risk Factors for Developing Metabolic Acidosis after Radical Cystectomy and Ileal Neobladder.
abstract: OBJECTIVE
  To investigate the serial changes of metabolic acidosis and identify associated risk factors in patients who underwent radical cystectomy and ileal neobladder.
  
  
  METHODS
  From January 2010 to August 2014, 123 patients who underwent radical cystectomy and ileal neobladder reconstruction for bladder cancer were included in this study. Metabolic acidosis was defined as a serum bicarbonate level less than 22 mEq/L and impaired renal function was defined as a GFR <50ml/min. The presence of metabolic acidosis was evaluated at 1 month, 1 year, and 2 years after surgery. Multivariate logistic regression analysis was conducted to identify risk factors associated with development of metabolic acidosis.
  
  
  RESULTS
  Metabolic acidosis was observed in 52%, 19.5%, and 7.3% of patients at 1 month, 1 year, and 2 years after surgery, respectively. At 1 month after surgery, impaired renal function was the only independent risk factor associated with metabolic acidosis (OR 3.87, P = 0.046). At 1 year after surgery, diabetes was the only independent risk factor associated with metabolic acidosis (OR 5.68, P = 0.002). At 2 years post-surgery, both age and diabetes were significant risk factors associated with metabolic acidosis.
  
  
  CONCLUSIONS
  Approximately, half of patients experienced metabolic acidosis one month after ileal neobladder reconstruction. Preoperative impaired renal function was the most significant risk factor for developing metabolic acidosis in the early postoperative period. However, the incidence of metabolic acidosis decreased to less than 20% 1 year after surgery, and diabetes was an independent risk factor during this period.
authors.affiliation: Department of Urology, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Kwang Hyun
authors.identifier: http://orcid.org/0000-0002-6264-5109
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Urology, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Hyun Suk
authors.initials: HS
authors.lastname: Yoon
authors.affiliation: Department of Urology, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Hana
authors.initials: H
authors.lastname: Yoon
authors.affiliation: Department of Urology, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Woo Sik
authors.initials: WS
authors.lastname: Chung
authors.affiliation: Department of Urology, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Bong Suk
authors.initials: BS
authors.lastname: Sim
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Dong-Ryeol
authors.initials: DR
authors.lastname: Ryu
authors.affiliation: Department of Urology, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Dong Hyeon
authors.initials: DH
authors.lastname: Lee
mesh_terms: D000138:Acidosis / Q000209:etiology*; D000368:Aged; D001639:Bicarbonates / Q000097:blood; D015331:Cohort Studies; D015653:Cystectomy / Q000009:adverse effects*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects*
chemical_list: D001639:Bicarbonates