Investigators have identified risk factors for glomerular filtration rate (GFR) decline after radical cystectomy (RC) for muscle-invasive or high-risk nonmuscle-invasive bladder cancer.

In a systematic review and meta-analysis of 10 studies involving 15,502 patients, advanced age was significantly associated with a 3% increased risk of kidney function loss per year of age. Lower preoperative kidney function, higher Charlson comorbidity index, diabetes, and hypertension were significantly associated with a 22%, 50%, 27%, and 24% increased risk of GFR decline after RC, respectively, Hooman Djaladat, MD, of the Institute of Urology, University of Southern California in Los Angeles, California, and colleagues reported in European Urology Focus. Locally advanced bladder cancer and ureteroenteric stricture were significantly associated with a 5.1- and 1.9-fold increased risk of postoperative GFR decline, respectively.

Postoperative hydronephrosis – but not preoperative hydronephrosis – was significantly associated with a 69% increased risk of kidney function loss after RC.

Patient sex, perioperative chemotherapy, and diversion type (continent or incontinent) were not associated with kidney function decline, the investigators reported.

In a meta-analysis of 7 studies involving 6900 patients, preoperative CKD stage 3-4 significantly decreased metastasis-free, cancer-specific, and overall survival by 1.5-, 2.1-, and 1.5-fold, respectively, the investigators reported.

Risk Factors Identified for Kidney Function Decline After Radical Cystectomy

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