The Natural History of Postoperative Renal Function in Patients Undergoing Ileal Conduit Diversion for Cancer Measured Using Serial Isotopic Glomerular Filtration Rate and ^99m Technetium-Mercaptoacetyltriglycine Renography

Abstract

Of patients with an ileal conduit 29% have renal function deterioration in the long term. No surgical cause for glomerular filtration rate deterioration was found in 18%. Important predisposing factors in nonobstructed cases were hypertension, recurrent urinary sepsis and a glomerular filtration rate of less than 50 ml per minute per 1.73 m. Hypertension was an independent predictor of a decreased glomerular filtration rate in the group with worsening glomerular filtration rates. In 11% of patients deterioration was due to upper tract obstruction. This was identifiable using renography and the glomerular filtration rate. A type IIIb curve was an early indicator of obstruction.

Risk of End Stage Kidney Disease after Radical Cystectomy According to Urinary Diversion Type

“…6 Samuel et al evaluated renal function after IC using 99m technetium-mercaptoacetyltriglycine renography and noted that 29% of patients had evidence of renal function deterioration with worsening GFR. 16 Jin et al evaluated a cohort of patients with IC and CD, and found that approximately 25% had a GFR decrease of greater than 10 ml/minute/1.73 m 2 at 10-year followup. 17 Additional single institution studies identified rates of renal deterioration as high as 70% 10 years after cystectomy.…”

Renal dysfunction following ileal conduit urinary diversions after radical cystectomy: a five year follow-up study

“…This result is comparable to the previous study in which there was 18-29% of patients revealed worsening of renal function during a median follow-up of 8 years. 6 Chemotherapy after radical cystectomy was found to be a significant determinant of postoperative renal function. M-VAC is the standard regimen which was used.…”

“…5 Samuel et al showed that 18% of sources were non-surgical. 6 Studies have shown that risk factors such as age, gender, hypertension, diabetes, preoperative ABSTRACT Background: Ileal conduit (IC) is the most commonly performed urinary diversions (UD) contributing 33-72 % of all types of UD with. Ileal conduits are relatively easy and quick to create, with a low rate of surgical complications.…”

Correlation of estimated and measured glomerular filtration rate in patients with interposed bowel in the urinary tract

“…Renal function impairment in patients with bowel interposition in the urinary tract is generally attributed to obstructive causes with or without recurrent infection or hypertension [7]. Early detection of renal function deterioration and identification of causative factors are crucial in preserving renal function in this group of patients.…”