Speakers - WNSC 2024

Abstract

Objective: To systematically evaluate the incidence of renal insufficiency after radical cystectomy in patients and its influencing factors, providing reference evidence for clinical practice to develop effective intervention measures.

Methods: We included Chinese and English language studies retrieved from China National Knowledge Infrastructure, VIP, Wanfang, China Biology Medicine disc, PubMed, Web of Science, and Embase from establishing each database until September 30, 2023. Two researchers independently screened the literature and assessed the quality according to the inclusion and exclusion criteria. The incidence rate was analyzed using stata14 software, and descriptive analysis was performed for the influencing factors.

Results:  A total of 16 studies with 7,336 patients were included. The meta-analysis showed that the incidence rate of renal insufficiency after radical cystectomy was 30% (95%CI: 0.25~0.35). Subgroup analysis revealed higher rates of renal insufficiency in studies with a duration of 5 years or more (0.30, 95%CI: 0.24~0.37), studies conducted in Asia (0.35, 95%CI: 0.28~0.42), and postoperative eGFR < 45 ml·min-1·1.73·m-2 (0.33, 95%CI: 0.29~0.36). Descriptive analysis results indicated that age, body mass index, diabetes, hypertension, preoperative eGFR, hydronephrosis, urinary tract infection, ureteral stricture, acute kidney injury, chemotherapy, urinary diversion method, and tumor staging were risk factors for renal insufficiency.

Conclusion: The overall incidence rate of renal insufficiency after radical cystectomy is 30%, and the risk increases with prolonged surgery time. There are multiple influencing factors. Healthcare professionals should prioritize screening and continuity of care for high-risk populations of postoperative renal insufficiency and intervene on high-risk factors to reduce the incidence of renal insufficiency.