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Metabolic Complications in Patients Undergoing Cystectomy with Unilateral Nephrectomy

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Metabolic Complications in Patients Undergoing Radical Cystectomy with Unilateral Nephrectomy

Mitri Khoury, Gus Miranda, Siamak Daneshmand, M.D., Hooman Djaladat M.D., M.S. 

 

Background

•Patients undergoing radical cystectomy and urinary diversion are susceptible to a variety of metabolic derangements post-operatively. This could be more complex if they have only one kidney
•We investigated patients with unilateral nephrectomy (for non-functioning kidney) with cystectomy (for bladder cancer) for electrolyte, metabolic, and renal function
 
Materials and Methods
•15 patients who met inclusion criteria and had >6 months f/u were retrospectively reviewed for changes in eGFR, electrolytes, and acidosis
•Median Follow-up (months) was 40.6 (7.2-97.2)
•eGFR was determined via the CKD formula 
 
Results
•3 patients with ileal conduits and 1 patient with orthotopic neobladder developed new-onset chronic kidney disease
•There was no significant changes in potassium, chloride, bicarbonate, and hematocrit post-operatively 
 
Conclusion
• Patients undergoing cystectomy with unilateral nephrectomy (for non-functioning kidney) appear to have a decline in eGFR from their baseline during their post-operative course (especially first  12 months) irrespective of diversion type 
• Future studies with more number of cases would help to better understand the single  versus two-kidney models after cystectomy