Comparison of a Significant Decline in the Glomerular Filtration Rate between Ileal Conduit and Ileal Neobladder Urinary Diversions after Radical Cystectomy: A Propensity Score-Matched Analysis

• Main Authors: Jihion Yu, Bumsik Hong, Jun-Young Park, Yongsoo Lee, Jai-Hyun Hwang, Yu-Gyeong Kong, Young-Kug Kim
• Format: Article
• Language: English
• Published: MDPI AG 2020-07-01
• Series: Journal of Clinical Medicine
• Subjects: radical cystectomy; ileal conduit urinary diversion; ileal neobladder urinary diversion; glomerular filtration rate
• Online Access: https://www.mdpi.com/2077-0383/9/7/2236

Urinary diversion after radical cystectomy is associated with a risk of renal function impairment. A significant decline in the glomerular filtration rate (GFR) (i.e., a ≥30% decline in baseline GFR after 12 months) is associated with long-term renal function impairment. We compared the significant GFR decline between ileal conduit and ileal neobladder urinary diversions 12 months after radical cystectomy. We retrospectively included radical cystectomy patients. Propensity score-matched analysis was performed. The primary outcome was the incidence of a significant GFR decline in ileal conduit urinary diversion (ileal conduit group) and ileal neobladder urinary diversion (ileal neobladder group) 12 months after radical cystectomy. The secondary outcomes were the change of GFR and the incidence of end-stage renal disease (ESRD) in the two groups. After propensity score matching, the ileal conduit and neobladder groups had 117 patients each. The incidence of a significant GFR decline was not significantly different between ileal conduit and ileal neobladder groups (12.0% vs. 13.7%, <i>p</i> = 0.845). The change of GFR and ESRD incidence were not significantly different between the two groups (−8.4% vs. −9.7%, <i>p</i> = 0.480; 4.3% vs. 5.1%, <i>p </i>><i> </i>0.999, respectively). These results can provide important information on appropriate selection of the urinary diversion type in radical cystectomy.