Kidney Week

Abstract: SA-PO1255

Renal Scintigraphy in the Management of Kidney Dysfunction After Cystectomy and Urinary Diversion in Patients with Cancer: A Case Series

Session Information

• Onconephrology: Epidemiological Trends, Risk Stratification, and Clinical Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Onconephrology

• 1600 Onconephrology

Authors

• Kassar, Liliana M L, Universidade de Sao Paulo Faculdade de Medicina, São Paulo, SP, Brazil

Liliana M L Kassar, MD

• Mattedi, Francisco Zanotelli, Universidade de Sao Paulo Faculdade de Medicina, São Paulo, SP, Brazil

Francisco Zanotelli Mattedi, MD

• Caires, Renato A., Universidade de Sao Paulo Faculdade de Medicina, São Paulo, SP, Brazil

Renato A. Caires, MD

• Lutf, Luciana Gil, Universidade de Sao Paulo Faculdade de Medicina, São Paulo, SP, Brazil

Luciana Gil Lutf, MD

• Segura, Gabriela C., Universidade de Sao Paulo Faculdade de Medicina, São Paulo, SP, Brazil

Gabriela C. Segura, MD

• Costa e Silva, Veronica Torres, Universidade de Sao Paulo Faculdade de Medicina, São Paulo, SP, Brazil

Veronica Torres Costa e Silva, MD, PhD

Background

Patients submitted to radical cystectomy and urinary diversion (RCUD) are at a higher risk for glomerular filtration rate (GFR) decline in the middle and long term due to urinary infections and anatomic complications. Nuclear imaging exams such as ^99mTc- DTPA diuretic and ^99mTc-DMSA may identify these events, but are frequently underused.

Methods

We conducted a retrospective case series of patients submitted to RCUD from a tertiary cancer center developing kidney dysfunction and/or hydronephrosis. Estimated glomerular filtration rate was based on the serum level of creatinine (Scr) (eGFRcr), expressed in ml/min/1.73m².

Results

Ten illustrative cases at follow-up at the nephrology outpatient clinic were analyzed. Median age was 65 (31–79) years; 70% were male. Underlying malignancies included bladder cancer (n=8), rectal adenocarcinoma (n=1), and urachal neoplasm (n=1). Urinary diversion subtypes included ileal conduit (n=9) and neobladder (n=1). Median eGFRcr at baseline was 45 (27-62). All patients performed a DTPA and seven a DMSA due to eGFRcr decline and/or new hydronephrosis at a median of 21 (4-140) months after cystectomy. At this moment, median eGFRcr decline was 24 (0-37) compared to the baseline and all patients had new hydronephrosis on abdominal CT scan. DTPA was suggestive of clinically significant obstructive uropathy in four exams, while DMSA demonstrated lateralization and renal scars in five. All patients with abnormal findings in the DTPA and three in the DMSA underwent urological interventions. Median eGFRcr six months after interventions was 28 (22-34) (Table).

Conclusion

This case series supports the use of renal scintigraphy techniques to select patients who may benefit from surgical interventions aimed at preserving kidney function after RCUD.