Measured glomerular filtration rate (GFR) significantly and rapidly decreases after radical cystectomy for bladder cancer.
- Rouanne M Department of Urology, Hôpital Foch, Université Paris-Saclay, 40, Rue Worth, 92150, Suresnes, France. rouanne.mathieu@gmail.com.
- Gaillard F Department of Physiology, Functional Explorations Unit, Hôpital Européen Georges Pompidou, Paris, France.
- Meunier M Department of Urology, Hôpital Foch, Université Paris-Saclay, 40, Rue Worth, 92150, Suresnes, France.
- Soorojebally Y Department of Urology, Hôpital Foch, Université Paris-Saclay, 40, Rue Worth, 92150, Suresnes, France.
- Phan H Department of Biostatistics, Hôpital Européen Georges Pompidou, Paris, France.
- Slimani-Thevenet H Department of Nuclear Medicine, Hôpital Européen Georges Pompidou, Paris, France.
- Jannot AS Department of Biostatistics, Hôpital Européen Georges Pompidou, Paris, France.
- Neuzillet Y Department of Urology, Hôpital Foch, Université Paris-Saclay, 40, Rue Worth, 92150, Suresnes, France.
- Friedlander G Department of Physiology, Functional Explorations Unit, Hôpital Européen Georges Pompidou, Paris, France.
- Froissart M Clinical Research Center and Trial Unit, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
- Botto H Department of Urology, Hôpital Foch, Université Paris-Saclay, 40, Rue Worth, 92150, Suresnes, France.
- Houillier P Department of Physiology, Functional Explorations Unit, Hôpital Européen Georges Pompidou, Paris, France.
- Lebret T Department of Urology, Hôpital Foch, Université Paris-Saclay, 40, Rue Worth, 92150, Suresnes, France.
- Courbebaisse M Department of Physiology, Functional Explorations Unit, Hôpital Européen Georges Pompidou, Paris, France.
- 2020-10-01
Published in:
- Scientific reports. - 2020
English
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 51Cr-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 m2) 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 m2 (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.
- Language
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- English
- Open access status
- gold
- Identifiers
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- DOI 10.1038/s41598-020-73191-0
- PMID 32999403
- Persistent URL
- https://sonar.rero.ch/global/documents/115670
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