Measured glomerular filtration rate (GFR) significantly and rapidly decreases after radical cystectomy for bladder cancer.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_0BBDE205B7A3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Measured glomerular filtration rate (GFR) significantly and rapidly decreases after radical cystectomy for bladder cancer.
Journal
Scientific reports
Author(s)
Rouanne M., Gaillard F., Meunier M., Soorojebally Y., Phan H., Slimani-Thevenet H., Jannot A.S., Neuzillet Y., Friedlander G., Froissart M., Botto H., Houillier P., Lebret T., Courbebaisse M.
ISSN
2045-2322 (Electronic)
ISSN-L
2045-2322
Publication state
Published
Issued date
30/09/2020
Peer-reviewed
Oui
Volume
10
Number
1
Pages
16145
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
Precise determination of glomerular filtration rate (GFR) is essential for the management of patients with muscle-invasive bladder cancer (MIBC). We aim to describe the early evolution of measured GFR (mGFR) after radical cystectomy and urinary diversion (RCUD) and to identify risk factors for GFR decline. GFR measurement using <sup>51</sup> Cr-EDTA continuous infusion, estimated GFR (eGFR) from five published equations and renal scintigraphy with split renal function determination were performed before and 6 months after RCUD. Chronic Kidney Disease (mGFR < 60 mL/min/1.73 m <sup>2</sup> ) and GFR stages were defined according to the KDIGO guidelines using mGFR. Twenty-seven patients (men 85%, median age 65, IQR 59; 68 years) were included. A total of 20 (74%) patients experienced significant mGFR decline at 6 months postoperatively. Median mGFR decreased from 84.1 pre-operatively (IQR 65.3; 97.2) to 69.9 mL/min/1.73 m <sup>2</sup> (IQR 55.0; 77.9) 6 months after surgery (p < 0.001). Thirteen (48%) patients had a progression to a worse GFR stage. Of the 22 patients without pre-operative CKD, 5 (23%) developed post-operative CKD. Diabetes mellitus was more frequent in patients in the highest tertile of relative mGFR decline (44% vs. 11%, p = 0.02) and platinum-based adjuvant chemotherapy tended to be more frequently used in these patients (44% vs. 17%, p = 0.06). Importantly, pre-operative weight was independently and negatively associated with post-operative mGFR and with mGFR slope in multivariable analyses. In this prospective series, we demonstrated that early and significant mGFR decline occurred after RCUD and perioperative platinum-based chemotherapy, especially in patients with diabetes mellitus and overweight.
Pubmed
Web of science
Open Access
Yes
Create date
09/10/2020 15:03
Last modification date
27/01/2021 7:27
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