Bladder cancer is the tenth most common cancer and the 14th leading cause of cancer death. Chronic kidney disease (CKD) is often seen in patients undergoing radical cystectomy (RC), a procedure done to treat bladder cancer. 

Could CKD be affecting outcomes of RC? Researchers collected and analyzed data to determine the impact of CKD on perioperative and oncologic outcomes after the procedure. Learn more about what the researchers did, what they found, and what it means. 

What They Did

Between 2009 and 2019, researchers gathered data from 1,214 patients undergoing RC. Patients were divided into three categories based on their glomerular filtration rate (GFR), which were:

• Group A = GFR>60 (Normal)
• Group B = GFR>30-59 (Stage 3 CKD) 
• Group C = GFR <30 (Stage 4 CKD)

Researchers then compared pre-, intra-, and postoperative characteristics, oncological outcomes, and 90-day perioperative outcomes. 

What They Found

When comparing groups, patients with worse CKD were older and had significantly worse overall comorbidity. In addition, worse CKD was associated with:

• Higher pathological stage
• Lymph nodes metastases 
• Positive soft tissue surgical margins 
• Higher blood transfusion rates
• Increased 90-day perioperative complications and readmissions
• Worse overall survival rate
• Adverse pathology 

What It Means

CKD is associated with negative outcomes and a higher likelihood of surgical complications. While more research is imperative, physicians should weigh the risks and benefits of RC with patients in advanced stages of CKD. 

*Charnow, J. A. (2021, September 13). CKD Associated With Worse Radical Cystectomy Outcomes. Renal and Urology News. https://www.renalandurologynews.com/home/conference-highlights/aua-2021/chronic-kidney-disease-ups-risks-for-adverse-outcomes-after-radical-bladder-cancer-surgery/

MP41-05: Chronic Kidney Disease and Radical Cystectomy for Bladder Cancer: Perioperative and Oncologic Outcomes in 1,214 Patients. (n.d.). American Urological Association. Retrieved September 20, 2021, from https://aua2021.app.swapcard.com/event/aua-2021-annual-meeting-1/planning/UGxhbm5pbmdfNjUwNzQ1