No abstract

Objectives To assess the role of the angiotensin receptor blocker losartan on the recoverability of renal function after de‐obstruction in patients with anuria and oliguria. Materials and Methods This was a double‐blind randomized placebo‐controlled trial in anuric or oliguric patients with calcular obstruction of solitary kidney. Patients with an anomalous kidney or those with an American Society of Anesthesiology score of >3 were excluded. After relief of obstruction, patients were allocated to receive either losartan potassium 25 mg or placebo for 3 months. Serum creatinine (sCr) and renographic glomerular filtration rate (GFR) were measured at nadir and after 3 months. Changes in sCr and renographic GFR were calculated by subtracting the values at nadir from those at 3 months. Improvement, stabilization or deterioration of sCr and renographic GFR were defined as percentage increase or decrease from nadir ≥10%, while changes <10% were considered as stabilization. Results A total of 76 patients completed 3 months of follow‐up. Demographics and peri‐operative data were comparable in the two groups. The median (range) sCr change was −1.05 (−1.8, 0.4) and −0.5 (−1.3, 0.1) mg/dL in the losartan and placebo, groups, respectively (P = 0.07). In the losartan group, renographic GFR had improved in 26 (59.1%) and deteriorated in six (13.6%) patients, while, in the placebo group, it had improved in eight (25%) and deteriorated in 10 patients (31.3%; P = 0.01). Losartan also enhanced renographic GFR improvement vs placebo by a median (range) of 6.9 (−9, 44) vs 1.4 (−10, 32) mL/min (P = 0.004). Conclusions In patients with anuria and oliguria, losartan treatment contributes to renal function recoverability after relief of calcular obstruction of the solitary kidney.

No abstract

detected pulmonary embolism) and timing of TEE (before or after (< or > 30 days) RC) and Khorana score (established for cancer patients treated with chemotherapy, based on baseline hemoglobin, platelet and leukocyte counts, BMI and tumor site) was determined for all patients. All patients received TEE prophylaxis during the early post-RC period. Multivariate analysis was performed on 827 patients. Kaplan Meier survival curves and log rank test were used to compare survival between patients who developed TEE and those who did not.RESULTS: The Khorana criteria indicated intermediate TEE risk in most patients. Khorana risk score was 1 or 2 in 88% of patients. Overall, the incidence of TEE in patients was 15%. 59 TEE were detected pre-operatively (7.1%), 21 early within 30 days of RC (2.5%) and 36 late post-operatively (4.3%). 32% of the TEE events were detected incidentally by imaging, 68% were detected clinically. Median overall survival of patients who developed TEE was 28 months compared to 71 months for those who did not develop TEE (p¼0.012).CONCLUSIONS: This multi-centre retrospective study suggests that TEE are very common in bladder cancer patients undergoing NAC before and after RC and they associate with poorer survival. Further investigation with a prospective prevention trial for the period of NAC is warranted.

pneumological and skin irAEs were not. Development of ! Grade 3 irAEs, absence of visceral metastases, ECOG-performance status (0-1), and baseline CRP (<5.0 mg/L) were independent favourable predictors of OS.CONCLUSIONS: Endocrine irAE was associated with higher ORR and improved survival in patients with advanced urothelial cancer treated with pembrolizumab.