Pelvic exenteration associated with future renal dysfunction

Sando, Masanori; Uehara, Kay; Li, Yuanying; Aiba, Toshisada; Ogura, Atsushi; Kodera, Yasuhiro; Yatsuya, Hiroshi; Nagino, Masato

doi:10.1007/s00595-020-02036-0

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“…Additionally, it is a well-known independent risk factor for increased mortality and cerebro-cardiovascular disease development. Although CKD is mainly caused by lifestyle diseases, such as diabetes mellitus, and hypertension, surgeons should recognize that surgical stress and various postoperative complications can lead to CKD [8,9]. Cerebrospinal disease or spinal cord injury reduces bladder capacity.…”

Section: Introductionmentioning

confidence: 99%

Renal Dysfunction after Rectal Cancer Surgery: A Long-term Observational Study

Sando

Uehara

et al. 2023

J Anus Rectum Colon

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Objectives: Despite the high incidence of urinary dysfunction (UD) after rectal surgery, it remains questionable whether UD causes future chronic kidney disease (CKD). This study aimed to clarify the long-term trends in renal function and risk factors for future CKD after rectal resection. Methods: For comparison, patients who underwent rectal resection (n = 129) and colectomy (n = 127) between 2006 and 2017 were identified. The estimated glomerular filtration rate (eGFR) ratio was calculated as the ratio to the baseline. "eGFR ratio < 0.75 at 3-year" was adopted as a surrogate indicator of future CKD. Results: eGFR ratio significantly decreased in the rectal cohort compared with the colon cohort at 1.5 years (0.9 vs. 0.95, p = 0.008) and at 3 years (0.85 vs. 0.94, p < 0.001). Although the preoperative prevalence of CKD was lower in the rectal than the colon cohort (13.9% vs. 23.6%, p = 0.055), it was similar at 3 years (29.5% vs. 30.7%). In multivariate analysis, females, and cT4 were independent risk factors for future CKD, but UD itself was not. Conclusions: Postoperative eGFR significantly decreased after rectal cancer surgery compared to colectomy. The prevalence of CKD more than doubled at 3 years after rectal resection. The female sex and cT4 tumor, instead of the UD, were independent risk factors for future CKD.

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Section: Introductionmentioning

confidence: 99%