Pelvic exenteration associated with future renal dysfunction

Masanori Sando, Kay Uehara, Yuanying Li, Toshisada Aiba, Atsushi Ogura, Tomoki Ebata, Yasuhiro Kodera, Hiroshi Yatsuya, Masato Nagino

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
JournalSurgery Today
DOIs
Publication statusAccepted/In press - 2020

All Science Journal Classification (ASJC) codes

  • Surgery

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    Sando, M., Uehara, K., Li, Y., Aiba, T., Ogura, A., Ebata, T., Kodera, Y., Yatsuya, H., & Nagino, M. (Accepted/In press). Pelvic exenteration associated with future renal dysfunction. Surgery Today. https://doi.org/10.1007/s00595-020-02036-0