Post-surgical outcomes of patients with chronic kidney disease and end stage renal disease undergoing radical prostatectomy: 10-year results from the US National Inpatient Sample

Chen, Ning; Hu, Xinyi; Liu, Fangming; Lin, Jun; Zhang, Jian; Wang, Zhipeng; Zhu, Yichen

doi:10.1186/s12882-019-1455-2

Cited by 19 publications

(23 citation statements)

References 22 publications

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“…Regarding the risk factors for the development of postoperative AKI, previous studies of the outcomes of cardiovascular surgery and liver transplantation demonstrated that advanced age, obesity, hypertension, diabetes mellitus, and intraoperative blood transfusion were common risk factors for the development of AKI 18‐20 . A recent large population‐based retrospective study showed that patients with CKD had five times greater risk of postoperative AKI after radical prostatectomy than patients in the non‐CKD group 21 . In our study, hypertension was a preoperative risk factor for early AKI, and diabetes mellitus was a preoperative risk factor for late AKI.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury and its impact on renal prognosis after robot‐assisted laparoscopic radical prostatectomy

Sato

Narita

Saito

et al. 2020

Robotics Computer Surgery

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Background: This study assessed the incidence and impact of acute kidney injury (AKI) on renal prognosis in patients who underwent robot-assisted laparoscopic radical prostatectomy (RARP). Methods: Medical records of 305 patients treated with RARP were retrospectively reviewed. The patients with postoperative AKIs were dichotomized into early AKI (immediately after surgery) and late AKI (1-7 days after surgery). The impact of AKIs and their risk factors were statistically assessed. Results: Early and late AKI were observed in 143 (46.9%) and 12 (3.9%) patients, respectively. Hypertension and console time were independent risk factors for early AKI. Among the patients with preoperative eGFR ≥60 mL/min, the eGFR decline 12 months after surgery was significantly greater in patients with early AKI than that without early AKI (−6.8 vs −3.2 mL/min, P = .02). Conclusions: Approximately half of patients developed early AKI after RARP. The patients with early AKI had reduced renal function 12 months after surgery. K E Y W O R D S acute kidney injury, prostate cancer, robot-assisted laparoscopic radical prostatectomy 1 | INTRODUCTION Prostate cancer is the second leading cause of cancer-related death in men worldwide. 1 Radical prostatectomy is one of the standard modalities for localized prostate cancer. 2 Robotic surgery has been accepted to improve surgical quality 3 in urological surgery, and robot-assisted laparoscopic radical prostatectomy (RARP) has become one of the most widely used procedures due to its minimal invasiveness and comparable outcomes with conventional procedures. 4,5 Therefore, it is important to achieve satisfactory surgical outcomes of RARP without peri-and postoperative complications. Acute kidney injury (AKI) is a postoperative complication of prostatectomy that is associated with chronic kidney disease (CKD) and death. 6,7 There are several potential causes of postoperative AKI, including patient and surgical factors. 7 RARP can impair renal function due to high pneumoperitoneum pressure and an extremely steep head-down position of the patient. 8,9 Several studies report the incidence of AKI after RARP compared with that after conventional open surgery. 7,10 However, the frequency and clinical significance of AKI after RARP remains unclear. In this study, we assessed the incidence, risk factors and impact on renal prognosis of AKI observed during the very early period after surgery in patients with prostate cancer who underwent RARP. 2 | PATIENTS AND METHODS 2.1 | Patients and study design We retrospectively reviewed the medical records of 305 consecutive patients with localized prostate cancer patients who underwent

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Section: Discussionmentioning

confidence: 99%

Acute kidney injury and its impact on renal prognosis after robot‐assisted laparoscopic radical prostatectomy

Sato

Narita

Saito

et al. 2020

Robotics Computer Surgery

View full text Add to dashboard Cite

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“…This key finding informs us that patients with a history of cancer are not more likely to develop AKI when hospitalized with COVID19. AKI is of particular concern for cancer patients as AKI is associated with the subsequent development of CKD, and CKD is associated with adverse post-operative outcomes in patients with prostate, kidney, and bladder cancer (17)(18)(19). Furthermore, CKD may reduce the oncologist's clinical armamentarium as several chemotherapeutic agents are nephrotoxic and optimal surveillance imaging often requires iodinated contrast enhancement (16).…”

Section: Discussionmentioning

confidence: 99%

“…AKI increases the risk of developing CKD (15), which is concerning for cancer patients as many oncologic therapies may result in renal impairment (16). Additionally, in patients with genitourinary malignancies, CKD has been associated with adverse post-operative outcomes (17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Cancer, Mortality, and Acute Kidney Injury Among Hospitalized Patients with SARS-CoV-2 Infection

Khusid

Becerra

Gallante

et al. 2020

Preprint

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Background: To evaluate COVID19 patients treated within our academic medical system to determine if history of malignancy, both in general and specifically in genitourinary oncology patients, is associated with adverse clinical outcomes, including AKI and mortality. Methods: We conducted a retrospective cohort study among patients with confirmed SARS-CoV-2 infection in a multi-hospital, academic medical institution in New York City. Outcomes included mortality, ICU admission and AKI among hospitalized patients. We also evaluated risk of hospitalization among all patients with SARS-CoV-2 infection. Multilevel logistic regression models were used for analysis. Results: We identified 6,893 patients who met inclusion criteria, of which 4,018 were hospitalized. Among hospitalized patients 374 (9%) had a history of cancer, 281 (7%) experienced AKI, and 1,045 (26%) died. In adjusted analyses, patients with a history of cancer had 1.33 (95% CI = 1.05, 1.69) times the odds of death compared to those without cancer and this appeared to be driven by lung cancer (OR= 2.44, 95% CI= 1.05, 4.39). Patients with a history of genitourinary cancer were not at higher risk of mortality compared to those without cancer (OR=0.99, 95% CI= 0.61, 1.62). History of cancer was not associated with ICU admission or AKI in overall and subgroup analyses. Conclusions: Patients with a history of cancer who are hospitalized with SARS-CoV-2 infection are not at greater risk for AKI, though they are at higher risk for mortality as compared to patients without a history of cancer. The increased risk in mortality appears driven by patients with pulmonary neoplasms. Patients with a history of genitourinary malignancies do not appear to be at higher risk for AKI or for mortality compared to the general population.

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“…This key finding informs us that patients with a history of cancer are not more likely to develop AKI when hospitalized with COVID19. AKI is of particular concern for cancer patients as AKI is associated with the subsequent development of CKD, and CKD is associated with adverse post-operative outcomes in patients with prostate, kidney, and bladder cancer (Kumar et al, 2014;Hamano et al, 2017;Ning et al, 2019). Furthermore, CKD may reduce the oncologist's clinical armamentarium as several chemotherapeutic agents are nephrotoxic and optimal surveillance imaging often requires iodinated contrast enhancement (Santos et al, 2020).…”

Section: Figure 1 Study Population and Cohort Definitionmentioning

confidence: 99%

“…AKI increases the risk of developing chronic kidney disease (CKD) (Belayev and Palevsky, 2014), which is concerning for cancer patients as many oncologic therapies may result in renal impairment (Santos et al, 2020). Additionally, in patients with genitourinary malignancies, CKD has been associated with adverse post-operative outcomes (Kumar et al, 2014;Hamano et al, 2017;Ning et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Cancer, Mortality, and Acute Kidney Injury among Hospitalized Patients with SARS-CoV-2 Infection

Khusid

Becerra

Gallante

et al. 2021

Asian Pac J Cancer Prev

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Background: To evaluate Coronavirus Disease 2019-(COVID19) patients treated within our academic medical system to determine if history of malignancy, both in general and specifically in genitourinary oncology patients, is associated with adverse clinical outcomes, including acute kidney injury (AKI) and mortality. Methods: We conducted a retrospective cohort study among patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a multi-hospital, academic medical institution in New York City. Outcomes included mortality, intensive care unit (ICU) admission and AKI among hospitalized patients. We also evaluated risk of hospitalization among all patients with SARS-CoV-2 infection. Multilevel logistic regression models were used for analysis. Results: We identified 6,893 patients who met inclusion criteria, of which 4,018 were hospitalized. Among hospitalized patients 374 (9%) had a history of cancer, 281 (7%) experienced AKI, and 1,045 (26%) died. In adjusted analyses, patients with a history of cancer had 1.33 (95% CI = 1.05, 1.69) times the odds of death compared to those without cancer and this appeared to be driven by lung cancer (odds ratio (OR) = 2.44, 95% CI= 1.05, 4.39). Patients with a history of genitourinary cancer were not at higher risk of mortality compared to those without cancer (OR=0.99, 95% CI= 0.61, 1.62). History of cancer was not associated with ICU admission or AKI in overall and subgroup analyses. Conclusions: Patients with a history of cancer who are hospitalized with SARS-CoV-2 infection are not at greater risk for AKI, though they are at higher risk for mortality as compared to patients without a history of cancer. The increased risk in mortality appears driven by patients with pulmonary neoplasms. Patients with a history of genitourinary malignancies do not appear to be at higher risk for AKI or for mortality compared to the general population.

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Post-surgical outcomes of patients with chronic kidney disease and end stage renal disease undergoing radical prostatectomy: 10-year results from the US National Inpatient Sample

Cited by 19 publications

References 22 publications

Acute kidney injury and its impact on renal prognosis after robot‐assisted laparoscopic radical prostatectomy

Acute kidney injury and its impact on renal prognosis after robot‐assisted laparoscopic radical prostatectomy

Cancer, Mortality, and Acute Kidney Injury Among Hospitalized Patients with SARS-CoV-2 Infection

Cancer, Mortality, and Acute Kidney Injury among Hospitalized Patients with SARS-CoV-2 Infection

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