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Introduction <p>Decline in renal function after Radical Cystectomy (RC) for bladder cancer, besides cancer recurrence and progression, is an important prognostic factor for survival. Although several studies worldwide have investigated the decline in renal function after RC, no large-scale analyses have been made in India. This study aimed to evaluate the long-term renal function following RC for bladder cancer and identify the risk factors associated with postoperative decline in renal function.</p> Methods <p>This retrospective single-centre study included patients who underwent RC from January 2014 to December 2018. Renal function was evaluated by estimated glomerular filtration rate (eGFR) by CKD-EPI 2021 formula using pre and postoperative serial creatinine measurements. Cox Proportional Hazards models were used to describe the loss of renal function and its association with clinicopathological variables, as well as its effect on mortality.</p> Results <p>After exclusions, 72 patients were eligible for analyses. Median follow-up time was 30.5 months. The proportion of patients with chronic kidney disease (CKD) stage G3 or worse increased from 9.45% before RC to 35.8% at 5 years after surgery, with 4.05% patients becoming dialysis dependent. Loss of renal function was associated with lower median survival (46 months vs. 56 months), although not statistically significant. In multivariate analysis, lower preoperative eGFR, preoperative hydroureteronephrosis, pre-existing hypertension, postoperative pyelonephritis and recurrent urinary tract infections were all independently associated with renal function decline.</p> Conclusion <p>The long-term renal function decreases considerably for a large number of RC patients. Recognizing preoperative risk factors could identify patients who benefit from enhanced renal surveillance or early intervention for modifiable factors to minimise renal insufficiency following RC.</p>

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Chronic Kidney Disease After Radical Cystectomy for Carcinoma Bladder: Incidence, Predictors, and Implications for Long-Term Surveillance

  • 期刊论文

  • 发表日期：

    2026年6月19日

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  • Aditi Deewan,
  • Rajeevalochana Parthasarathy,
  • Sanjeev Nair,
  • Shalini Shree Krishnamurthy,
  • Venkatraman Radhakrishnan,
  • Veenaa S Manjari,
  • Sukanya Govindan,
  • Syeda Hurmath,
  • Kenar Jhaveri,
  • Madhusri Babu,
  • Subashri Mohanasundaram,
  • Kanuj Malik,
  • Anand Raja

摘要

Introduction

Decline in renal function after Radical Cystectomy (RC) for bladder cancer, besides cancer recurrence and progression, is an important prognostic factor for survival. Although several studies worldwide have investigated the decline in renal function after RC, no large-scale analyses have been made in India. This study aimed to evaluate the long-term renal function following RC for bladder cancer and identify the risk factors associated with postoperative decline in renal function.

Methods

This retrospective single-centre study included patients who underwent RC from January 2014 to December 2018. Renal function was evaluated by estimated glomerular filtration rate (eGFR) by CKD-EPI 2021 formula using pre and postoperative serial creatinine measurements. Cox Proportional Hazards models were used to describe the loss of renal function and its association with clinicopathological variables, as well as its effect on mortality.

Results

After exclusions, 72 patients were eligible for analyses. Median follow-up time was 30.5 months. The proportion of patients with chronic kidney disease (CKD) stage G3 or worse increased from 9.45% before RC to 35.8% at 5 years after surgery, with 4.05% patients becoming dialysis dependent. Loss of renal function was associated with lower median survival (46 months vs. 56 months), although not statistically significant. In multivariate analysis, lower preoperative eGFR, preoperative hydroureteronephrosis, pre-existing hypertension, postoperative pyelonephritis and recurrent urinary tract infections were all independently associated with renal function decline.

Conclusion

The long-term renal function decreases considerably for a large number of RC patients. Recognizing preoperative risk factors could identify patients who benefit from enhanced renal surveillance or early intervention for modifiable factors to minimise renal insufficiency following RC.