Baseline kidney function predicts the likelihood of progressing to clinically significant chronic kidney disease (CKD) among patients undergoing radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC), according to data presented at the Society of Urologic Oncology 2020 virtual annual meeting.
In a study that included 3360 veterans, each 0.1 unit decrease in serum creatinine prior to RC was significantly associated with a 24% increased likelihood of progressing to stage 4 CKD (estimated glomerular filtration rate [eGFR] of less than 30 mL/min/1.73 m2) following surgery, after adjusting for multiple potential confounders, Bogdana Schmidt, MD, MPH, of Stanford University in Stanford, California, and colleagues reported.
The patients had a mean age of 67 years at the time of surgery and a median preoperative eGFR of 69 mL/min/1.73 m2. Of the 3360 patients, 829 (25%) progressed to stage 4 CKD within 6 months after surgery. In addition, lower baseline kidney function was significantly associated with an increased mortality risk.
“Our findings suggest that preoperative CKD stage should be incorporated into risk stratification algorithms for patients undergoing radical cystectomy,” the investigators concluded in their study abstract.
The study also found that preoperative hydronephrosis, adjuvant chemotherapy, and increasing Charlson Comorbidity Index score were associated with progressing to stage 4 CKD.
Schmidt B, Velaer K, Thomas IC, et al. Renal morbidity following radical cystectomy in patients with muscle-invasive bladder cancer. Presented at: Society of Urologic Oncology 2020 virtual annual meeting, December 3-5. Poster 11.