Evaluation of renal function after radical cystectomy in patients with bladder cancer

Radical cystectomy is performed by urinary diversion process which inevitable reconstruction of the lower urinary tract is required. Deterioration of renal function after radical cystectomy is one of the major causes of morbidity. In our study, we aimed to identify risk factors associated with deterioration of kidney function after radical cystectomy. 179 patients who underwent radical cystectomy surgery for bladder cancer included our study between January 2007 and December 2021. The variables were evaluated retrospectively. Renal function was determined using creatinine-based estimated glomerular filtration rate (GFR). Deterioration of renal function was described as a significant difference between GFRs in postoperative follow-up. At the first 6 months of follow-up, renal function deteriorated further as age increased (p <0.05). We found that the decrease of GFR in patients undergoing orthotopic new bladder was greater than ileal conduit and ureterocutaneostomy (p = 0.003 and p = 0.001, respectively). As the stage of bladder cancer increased, renal function deteriorated more (p=0.03). In the postoperative follow-up of the patients who had acute pyelonephritis, the deterioration of renal function was found to be significant (p=0.002). In conclusion, renal function in elderly patients after radical cystectomy is more impaired in the early period. The pathological stage of the tumor could be used to predict decreasing of renal function. Reducing the risk of infection can prevent deterioration of renal function.