Risk Factors for Developing Metabolic Acidosis after Radical Cystectomy and Ileal Neobladder

To investigate the serial changes of metabolic acidosis and identify associated risk factors in patients who underwent radical cystectomy and ileal neobladder. From January 2010 to August 2014, 123 patients who underwent radical cystectomy and ileal neobladder reconstruction for bladder cancer were...

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Published in:PloS one 2016-07, Vol.11 (7), p.e0158220-e0158220
Main Authors: Kim, Kwang Hyun, Yoon, Hyun Suk, Yoon, Hana, Chung, Woo Sik, Sim, Bong Suk, Ryu, Dong-Ryeol, Lee, Dong Hyeon
Format: Article
Language:English
Subjects:
Acidosis
Acidosis - etiology
Adenosine triphosphatase
Aged
Bicarbonate
Bicarbonates
Bicarbonates - blood
Biology and Life Sciences
Bladder
Bladder cancer
Cancer
Carbonates
Catheters
Cohort Studies
Cystectomy
Cystectomy - adverse effects
Development and progression
Diabetes
Diabetes mellitus
Electrolytes
Female
Gene expression
Glomerular Filtration Rate
Health risks
Humans
Laboratories
Male
Medicine
Medicine and Health Sciences
Metabolic acidosis
Metabolism
Middle Aged
Multivariate Analysis
Patient outcomes
Patients
Physical Sciences
Physiological aspects
Reconstruction
Regression analysis
Renal function
Risk analysis
Risk Factors
Rodents
Surgery
Time Factors
Treatment Outcome
Urinary Bladder - surgery
Urinary Bladder Neoplasms - surgery
Urinary Diversion - adverse effects
Urine
Urologic surgery
Urology
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creator Kim, Kwang Hyun
Yoon, Hyun Suk
Yoon, Hana
Chung, Woo Sik
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Ryu, Dong-Ryeol
Lee, Dong Hyeon
description To investigate the serial changes of metabolic acidosis and identify associated risk factors in patients who underwent radical cystectomy and ileal neobladder. From January 2010 to August 2014, 123 patients who underwent radical cystectomy and ileal neobladder reconstruction for bladder cancer were included in this study. Metabolic acidosis was defined as a serum bicarbonate level less than 22 mEq/L and impaired renal function was defined as a GFR
doi_str_mv 10.1371/journal.pone.0158220
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From January 2010 to August 2014, 123 patients who underwent radical cystectomy and ileal neobladder reconstruction for bladder cancer were included in this study. Metabolic acidosis was defined as a serum bicarbonate level less than 22 mEq/L and impaired renal function was defined as a GFR &lt;50ml/min. The presence of metabolic acidosis was evaluated at 1 month, 1 year, and 2 years after surgery. Multivariate logistic regression analysis was conducted to identify risk factors associated with development of metabolic acidosis. Metabolic acidosis was observed in 52%, 19.5%, and 7.3% of patients at 1 month, 1 year, and 2 years after surgery, respectively. At 1 month after surgery, impaired renal function was the only independent risk factor associated with metabolic acidosis (OR 3.87, P = 0.046). At 1 year after surgery, diabetes was the only independent risk factor associated with metabolic acidosis (OR 5.68, P = 0.002). At 2 years post-surgery, both age and diabetes were significant risk factors associated with metabolic acidosis. Approximately, half of patients experienced metabolic acidosis one month after ileal neobladder reconstruction. Preoperative impaired renal function was the most significant risk factor for developing metabolic acidosis in the early postoperative period. 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Performed the experiments: KHK HSY. Analyzed the data: KHK HSY. Contributed reagents/materials/analysis tools: HSY HY. Wrote the paper: KHK WSC BSS DR.</notes><notes>Competing Interests: The authors have declared that no competing interests exist.</notes><abstract>To investigate the serial changes of metabolic acidosis and identify associated risk factors in patients who underwent radical cystectomy and ileal neobladder. From January 2010 to August 2014, 123 patients who underwent radical cystectomy and ileal neobladder reconstruction for bladder cancer were included in this study. Metabolic acidosis was defined as a serum bicarbonate level less than 22 mEq/L and impaired renal function was defined as a GFR &lt;50ml/min. The presence of metabolic acidosis was evaluated at 1 month, 1 year, and 2 years after surgery. Multivariate logistic regression analysis was conducted to identify risk factors associated with development of metabolic acidosis. Metabolic acidosis was observed in 52%, 19.5%, and 7.3% of patients at 1 month, 1 year, and 2 years after surgery, respectively. At 1 month after surgery, impaired renal function was the only independent risk factor associated with metabolic acidosis (OR 3.87, P = 0.046). At 1 year after surgery, diabetes was the only independent risk factor associated with metabolic acidosis (OR 5.68, P = 0.002). At 2 years post-surgery, both age and diabetes were significant risk factors associated with metabolic acidosis. Approximately, half of patients experienced metabolic acidosis one month after ileal neobladder reconstruction. Preoperative impaired renal function was the most significant risk factor for developing metabolic acidosis in the early postoperative period. However, the incidence of metabolic acidosis decreased to less than 20% 1 year after surgery, and diabetes was an independent risk factor during this period.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27384686</pmid><doi>10.1371/journal.pone.0158220</doi><orcidid>https://orcid.org/0000-0002-6264-5109</orcidid><oa>free_for_read</oa></addata></record>
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subjects Acidosis
Acidosis - etiology
Adenosine triphosphatase
Aged
Bicarbonate
Bicarbonates
Bicarbonates - blood
Biology and Life Sciences
Bladder
Bladder cancer
Cancer
Carbonates
Catheters
Cohort Studies
Cystectomy
Cystectomy - adverse effects
Development and progression
Diabetes
Diabetes mellitus
Electrolytes
Female
Gene expression
Glomerular Filtration Rate
Health risks
Humans
Laboratories
Male
Medicine
Medicine and Health Sciences
Metabolic acidosis
Metabolism
Middle Aged
Multivariate Analysis
Patient outcomes
Patients
Physical Sciences
Physiological aspects
Reconstruction
Regression analysis
Renal function
Risk analysis
Risk Factors
Rodents
Surgery
Time Factors
Treatment Outcome
Urinary Bladder - surgery
Urinary Bladder Neoplasms - surgery
Urinary Diversion - adverse effects
Urine
Urologic surgery
Urology
title Risk Factors for Developing Metabolic Acidosis after Radical Cystectomy and Ileal Neobladder
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