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Kidney Week

Abstract: TH-PO075

AKI and Acute Kidney Disease After Radical Cystectomy for Muscle Invasive Bladder Cancer: A Hidden Uro-Nephrological Affair

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical‚ Outcomes‚ and Trials

Authors

  • Trevisani, Francesco, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Cinque, Alessandra, Biorek s.r.l., Milano, Lombardia, Italy
  • Floris, Matteo, Azienda Ospedaliera Brotzu, Cagliari, Sardegna, Italy
  • Longoni, Mattia, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Minnei, Roberto, Azienda Ospedaliera Brotzu, Cagliari, Sardegna, Italy
  • Bonzi, Camilla Maria Ester, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Rota, Maria Rita, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Salonia, Andrea, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Briganti, Alberto, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Montorsi, Francesco, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Moschini, Marco, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
Background

Radical cystectomy (RC) represents the first line surgical treatment for muscle-invasive bladder cancer (MIBC). RC is a complex surgical procedure characterized by significant morbidity and mortality. The incidence of significant complications following RC is a well-recognized issue
however still paucity of data exists regarding postoperative renal function. Aim of the study was to evaluate the incidence of acute kidney injury (AKI) and Acute kidney disease (AKD) after RC, evaluating the impact of surgery and comorbidities.

Methods

In this study, we collected a consecutive cohort of 280 patients who underwent RC for MIBC in a single tertiary institution. All clinical variables and comorbidities were reported pre and after surgery. Serum creatinine with subsequently eGFR using CKD-EPI formula were collected at
baseline pre-operative and in the acute setting at 24h, 48, 72h, 6 days for the AKI onset, and after 9,12,15,18,21,24,27,30,45, 60, 75, 90 days for the AKD establishment. Fisher's exact test; Wilcoxon rank sum test; Pearson's Chi-squared test were used for the statistical analysys.

Results

Clinical data are present in table 1. Surprisingly, the 51.4% of patients experience AKI and 37.5% of pts AKD. The unique risk factor using univariate analysis was the presence of hypertension at baseline. The surgical techniques did not have any influence. 23.6% of patients experence both AKI and AKD, while 13.9% of patients experience AKD, but not AKI.

Conclusion

Aki and AKD are very frequent side effects in the RC for MIBC and require the nephrological counseling immediately after the surgery to monitor the onset of AKI and AKD. Hypertension represents the main risk factor.