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Purpose <p>To investigate the effect of acidic urine (pH ≤ 5.5) on disease recurrence or progression in patients with nonmuscle-invasive bladder cancer (NMIBC) undergoing transurethral resection of bladder tumor (TURBT) followed by intravesical Bacillus Calmette–Guérin (BCG) induction therapy.</p> Methods <p>A total of 578 patients with intermediate- and high-risk NMIBC who underwent intravesical BCG induction after initial TURBT between May 2003 and April 2021 were included. Patients were subdivided into low (pH ≤ 5.5) and high (pH &gt; 5.5) urine pH groups.</p> Results <p>Patients with acidic urine showed higher fasting plasma glucose levels (<i>p</i> = 0.017), higher serum uric acid level (<i>p</i> = 0.011), lower estimated glomerular filtration rates (<i>p</i> = 0.022), and higher rates of abnormal urinary cytology (<i>p</i> = 0.021), but no significant differences were observed in context of adverse clinicopathological features. During a median follow-up period of 56 months, the acidic urine group had a lower recurrence-free survival rate than the high urine pH group (<i>p</i> = 0.009). In terms of disease progression, there was no difference according to urine pH status.</p> Conclusion <p>Acidic urine was associated with disease recurrence after intravesical BCG induction for NMIBC, despite no differences in adverse clinicopathological features according to urine acidity.</p>

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Acidic urine as a prognostic factor after intravesical Bacillus Calmette–Guérin induction therapy for nonmuscle-invasive bladder cancer

  • 期刊论文

  • 发表日期：

    2025年4月25日

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  • Hoyoung Ryu,
  • Sangchul Lee,
  • Sang Hun Song,
  • Hakmin Lee,
  • Jong Jin Oh,
  • Sung Kyu Hong,
  • Seok-Soo Byun,
  • Byeongdo Song

摘要

Purpose

To investigate the effect of acidic urine (pH ≤ 5.5) on disease recurrence or progression in patients with nonmuscle-invasive bladder cancer (NMIBC) undergoing transurethral resection of bladder tumor (TURBT) followed by intravesical Bacillus Calmette–Guérin (BCG) induction therapy.

Methods

A total of 578 patients with intermediate- and high-risk NMIBC who underwent intravesical BCG induction after initial TURBT between May 2003 and April 2021 were included. Patients were subdivided into low (pH ≤ 5.5) and high (pH > 5.5) urine pH groups.

Results

Patients with acidic urine showed higher fasting plasma glucose levels (p = 0.017), higher serum uric acid level (p = 0.011), lower estimated glomerular filtration rates (p = 0.022), and higher rates of abnormal urinary cytology (p = 0.021), but no significant differences were observed in context of adverse clinicopathological features. During a median follow-up period of 56 months, the acidic urine group had a lower recurrence-free survival rate than the high urine pH group (p = 0.009). In terms of disease progression, there was no difference according to urine pH status.

Conclusion

Acidic urine was associated with disease recurrence after intravesical BCG induction for NMIBC, despite no differences in adverse clinicopathological features according to urine acidity.