title: Acid-base disorders after orthotopic bladder replacement: comparison of an ileal neobladder and an ileal conduit.
abstract: OBJECTIVE
  For many years, creation of an orthotopic neobladder after cystectomy has been popular. In the present study, we measured the extent of metabolic acidosis in patients with ileal neobladders compared with ileal conduits and defined risk factors for development of metabolic acidosis.
  
  
  METHODS
  We retrospectively studied 95 patients, who underwent radical cystectomy and urinary diversion to treat invasive bladder cancer from January 2001 to December 2014 at Hallym University Kangnam Sacred Heart Hospital, through investigation of acid-base balance, serum electrolyte levels and renal function one month and one year after operation.
  
  
  RESULTS
  One month after the operation, metabolic acidosis was found from 18 patients (31.0%) in an ileal neobladder group and from 4 (14.8%) in an ileal conduits group. One year after the operation, the numbers became 11 (22.9%) and 2 (10.0%), respectively. However, there was not a statistical difference. The blood biochemical profiles of the two groups did not differ significantly after urinary diversion. Logistic analysis revealed that lower estimated glomerular filtration rate (eGFR) was associated with metabolic acidosis at one month (odds ratio, OR = 0.94 [0.91-0.97]; p < 0.001) and one year (OR = 0.94 [0.92-0.97]; P = 0.001) after urinary diversion. In multivariate analysis, lower eGFR is a significant risk factor for metabolic acidosis at one month.
  
  
  CONCLUSIONS
  Patients with ileal neobladders and conduits are at the similar risk of metabolic acidosis. A close association between renal function and development of metabolic acidosis was observed, especially stronger in an early period after operation.
authors.affiliation: a Division of Nephrology, Department of Internal Medicine.
authors.forename: AJin
authors.initials: A
authors.lastname: Cho
authors.affiliation: a Division of Nephrology, Department of Internal Medicine.
authors.forename: Seung Min
authors.initials: SM
authors.lastname: Lee
authors.affiliation: a Division of Nephrology, Department of Internal Medicine.
authors.forename: Jung Woo
authors.initials: JW
authors.lastname: Noh
authors.affiliation: b Department of Urology , Hallym Kidney Research Institute, Hallym University College of Medicine, Kangnam Sacred Heart Hospital , Seoul , Korea.
authors.forename: Don Kyoung
authors.initials: DK
authors.lastname: Choi
authors.affiliation: b Department of Urology , Hallym Kidney Research Institute, Hallym University College of Medicine, Kangnam Sacred Heart Hospital , Seoul , Korea.
authors.forename: Yongseong
authors.initials: Y
authors.lastname: Lee
authors.affiliation: b Department of Urology , Hallym Kidney Research Institute, Hallym University College of Medicine, Kangnam Sacred Heart Hospital , Seoul , Korea.
authors.forename: Sung Tae
authors.initials: ST
authors.lastname: Cho
authors.affiliation: b Department of Urology , Hallym Kidney Research Institute, Hallym University College of Medicine, Kangnam Sacred Heart Hospital , Seoul , Korea.
authors.forename: Ki Kyung
authors.initials: KK
authors.lastname: Kim
authors.affiliation: b Department of Urology , Hallym Kidney Research Institute, Hallym University College of Medicine, Kangnam Sacred Heart Hospital , Seoul , Korea.
authors.forename: Young Goo
authors.initials: YG
authors.lastname: Lee
authors.affiliation: a Division of Nephrology, Department of Internal Medicine.
authors.forename: Young Ki
authors.initials: YK
authors.lastname: Lee
mesh_terms: D000136:Acid-Base Equilibrium; D000138:Acidosis / Q000097:blood / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D015653:Cystectomy / Q000379:methods; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007082:Ileum / Q000601:surgery*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects* / Q000379:methods*; D016476:Urinary Reservoirs, Continent
chemical_list: D003404:Creatinine
keywords: Conduit; ileum; metabolic acidosis; neobladder; renal function