Ankara Atatürk Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Ankara, Türkiye**
Ankara Üniversitesi Tıp Fakültesi, Üroloji Anabilim Dalı, Ankara, Türkiye
Objective: Renal function deterioration develops in most of the patients treated with radical cystectomy (RC). In this study, we aimed to evaluate the changes in renal function of bladder cancer (BC) patients who had minimum 5 years of follow-up period after RC.
Materials and Methods: In this study, 175 patients who underwent RC for BC at our institution between January 1995 and December 2010 were included. Age, gender, baseline glomerular filtration rate (GFR) before RC, tumor histology, pathological tumor stage, comorbidity record and presence of hydronephrosis before treatment were evaluated. GFR was calculated with the modification of diet in renal disease equation. GFR measurements of every 6 months were recorded in the follow-up.
Results: The mean age and mean GFR before RC were 66.5±17.9 years and 91.1±18.2 mL/min, respectively. Patients separated into two groups for having ileal conduit diversion and ileal substitution (IS). It was found out that although baseline GFRs were similar for both groups, GFR was significantly lower in patients of RC with IS after the first year of follow-up period. According to multivariate logistic analysis, having IS as a diversion method (p=0.0001, odds ratio (OR): 3.2, 95% confidence interval (CI): 1.248-5.481), presence of diabetes mellitus record (p=0.0001, OR: 4.9, 95% CI: 2.575-9.706) and presence of hypertension record (p=0.0001, OR: 3.6, 95% CI: 2.019-6.552) were found to be associated with decrease in GFR.
Conclusion: Renal function deterioration mostly develops in patients after RC surgery within 5 years. Renal function deterioration was more prominent in IS patients who had diabetes mellitus, hypertension record.