TY - JOUR
T1 - Pelvic exenteration associated with future renal dysfunction
AU - Sando, Masanori
AU - Uehara, Kay
AU - Li, Yuanying
AU - Aiba, Toshisada
AU - Ogura, Atsushi
AU - Ebata, Tomoki
AU - Kodera, Yasuhiro
AU - Yatsuya, Hiroshi
AU - Nagino, Masato
N1 - Publisher Copyright:
© 2020, Springer Nature Singapore Pte Ltd.
PY - 2020/12
Y1 - 2020/12
N2 - Purpose: This study aimed to clarify the long-term change in the renal function after pelvic exenteration (PE) and to evaluate the risk factors for any future dysfunction. Methods: This study comprised 40 patients. A greater than 25% decline in the estimated glomerular filtration rate (eGFR) at 3 years was defined as early renal function disorder (ERFD), possibly predicting future chronic kidney disease (CKD). Results: In the entire cohort, the median eGFR decreased by 23% at 3 years, and CKD developed in 50%. The patients were divided into the ERFD (n = 16) and non-ERFD (n = 24) groups. In the ERFD group, the eGFR significantly decreased by 28% during the first 1.5 years and continued to decline after that, resulting in 81.3% of patients reaching CKD, whereas it was 4% and 37.5%, respectively, in the non-ERFD group. In a growth model analysis, late urinary tract complications (UTC) and small bowel obstruction were shown to be risk factors for ERFD. Conclusion: Although PE was associated with a high incidence of future CKD, ERFD could predict it. Close observation of the eGFR decline over 1.5 years might be beneficial to identify ERFD patients. High-risk patients with late UTC and small bowel obstruction should, therefore, be observed carefully.
AB - Purpose: This study aimed to clarify the long-term change in the renal function after pelvic exenteration (PE) and to evaluate the risk factors for any future dysfunction. Methods: This study comprised 40 patients. A greater than 25% decline in the estimated glomerular filtration rate (eGFR) at 3 years was defined as early renal function disorder (ERFD), possibly predicting future chronic kidney disease (CKD). Results: In the entire cohort, the median eGFR decreased by 23% at 3 years, and CKD developed in 50%. The patients were divided into the ERFD (n = 16) and non-ERFD (n = 24) groups. In the ERFD group, the eGFR significantly decreased by 28% during the first 1.5 years and continued to decline after that, resulting in 81.3% of patients reaching CKD, whereas it was 4% and 37.5%, respectively, in the non-ERFD group. In a growth model analysis, late urinary tract complications (UTC) and small bowel obstruction were shown to be risk factors for ERFD. Conclusion: Although PE was associated with a high incidence of future CKD, ERFD could predict it. Close observation of the eGFR decline over 1.5 years might be beneficial to identify ERFD patients. High-risk patients with late UTC and small bowel obstruction should, therefore, be observed carefully.
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U2 - 10.1007/s00595-020-02036-0
DO - 10.1007/s00595-020-02036-0
M3 - Article
C2 - 32488476
AN - SCOPUS:85085889430
SN - 0941-1291
VL - 50
SP - 1601
EP - 1609
JO - Surgery Today
JF - Surgery Today
IS - 12
ER -