Chronic Kidney Disease: Risk Factor for Muscle-Invasive Bladder Cancer?
Posted: Friday, January 29, 2021
The risk of cardiovascular events, hospitalization, and mortality is often increased in patients with chronic kidney disease. Bogdana Schmidt, MD, MPH, of Stanford University School of Medicine, California, and colleagues evaluated the development of chronic kidney disease in patients who underwent radical cystectomy for muscle-invasive bladder cancer. At the 2020 Annual Meeting of the Society of Urologic Oncology (SUO; Abstract 11), the researchers reported a direct relationship between baseline kidney function and development of chronic kidney disease.
“Baseline kidney function is an important risk factor for progressing to clinically significant chronic kidney disease following radical cystectomy, and an independent predictor of overall survival for bladder cancer after radical cystectomy,” the researchers concluded. “Our findings suggest that preoperative chronic kidney disease stages should be incorporated into risk stratification algorithms for patients undergoing radical cystectomy.”
The investigators focused on the national utilization files from the Veterans Health Administration to identify 3,360 patients who underwent muscle-invasive bladder cancer-related radical cystectomies. Serum creatinine values were acquired 6 months before surgery, and postoperative kidney function was estimated beginning 30 days after surgery.
The mean age of patients at surgery was 67, and the median preoperative estimated glomerular filtration rate was 69 mL/min/1.73 m2. Within 12 months, 25% of patients developed clinically significant chronic kidney disease. Preoperative hydronephrosis, older age at the time of surgery, increased comorbidity index, and receipt of adjuvant chemotherapy were shown to be factors that may lead to chronic kidney disease following radical cystectomy. Additionally, patients were more likely to develop chronic kidney disease if they received neoadjuvant carboplatin and/or an adjuvant cisplatin/carboplatin combinations. Baseline kidney function was found to be independently associated with overall survival.
Disclosure: No disclosure information was provided for the study authors.