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Peer-reviewedCC BY-NC-NDBMC urology

Predicting acute kidney injury after radical cystectomy for muscle-invasive bladder cancer.

  • Kays Chaker1
  • Ahmed Chaabouni2
  • Wafa Elleuch3
  • Aida Khadhar4
  • Khouloud Ouertani2
  • Ali Chakroun5
  • Afif Limem5
  • Yasmine Laabidi5
  • Wassim Ben Chedly5
  • Yassine Ouanes5
  • Mokhtar Bibi5
  • Mahdi Marrak5
3 more authors
  • Ines Chelly4
  • Mourad Hadj Slimene2
  • Yassine Nouira5
5 affiliations
  1. 1Department of Urology, La Rabta Hospital, The Faculty of Medicine of Tunis, University of Tunis Manar, Tunis, Tunisia. [email protected].
  2. 2Department of Urology, Habib Bourguiba Hospital, The Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.
  3. 3Pedagogy Committee of the Faculty of Medicine of Sfax, Physical medecine and rehabilitation Department, Military Hospital, Sfax, Tunisia.
  4. 4Department of Pathology, La Rabta Hospital, The Faculty of Medicine of Tunis, University of Tunis Manar, Tunis, Tunisia.
  5. 5Department of Urology, La Rabta Hospital, The Faculty of Medicine of Tunis, University of Tunis Manar, Tunis, Tunisia.
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Abstract

Introduction

Radical cystectomy (RC) with urinary diversion remains the gold standard for the treatment of muscle invasive tumors. RC is a major surgery associated with a high morbidity rate. Postoperative acute kidney injury (AKI) is associated with severe morbidity and mortality. In this study we attempted to identify risk factors for postoperative AKI in patients undergoing RC.Patients and methods

A multicenter retrospective analysis was conducted among patients treated with radical cystectomy for muscle-invasive bladder cancer between 2015 and 2024. AKI was defined by Kidney Disease Improving Global Outcomes (KDIGO), within 90 days of surgery, with the occurrence of 1 of the 3 items: (1) increase in serum creatinine by ≥ 26.5 µmol/L within 48 h; (2) increase in serum creatinine ≥ 1.5-time baseline, which is known or presumed to have occurred within the prior seven days; (3) urine volume < 0.5 ml/kg/h during 6 h, KDIGO score were also recorded. Data were compared between two groups of patients: occurrence of AKI within the first 30 days of the post-operative period (AKI group) or no AKI during this period (no AKI group).Results

We included 520 patients. The incidence of postoperative AKI was 40.38% (n = 210). Patients with AKI were active smoker (p = 0.03), significantly less often anemic (p = 0.01), had a higher BMI (p = 0.002), preoperative anemia (p = 0.01). Duration of surgery was longer in AKI patients (p < 0.001). AKI patients were more likely to need vasoactive agents (p = 0.04). Independent factors associated with AKI were intraoperative blood loss (OR = 4.8 [95%CI: 3.06-6.43]; p = 0.01), duration of surgery (OR = 3.36 [95%CI: 2.9-11.19]; p = 0.0014); Preoperative anemia (OR = 2.69 [95%CI: 1.06-5.2]; p < 0.001); use of vasoactive agents (OR = 6.36, [95%CI: 6.01-36.87]; p < 0.001). Postoperative AKI was not associated with 2-year mortality (p = 0.71).Conclusion

A significant number of patients experienced AKI after RC. Recognizing pre- and perioperative risk factors can identify patients where close surveillance and early intervention may help minimize renal function decline following RC.

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Cite

BibTeXRIS
BibTeX
@article{chaker2026predicting,
  title = {{Predicting acute kidney injury after radical cystectomy for muscle-invasive bladder cancer.}},
  author = {Kays Chaker and Ahmed Chaabouni and Wafa Elleuch and Aida Khadhar and Khouloud Ouertani and Ali Chakroun and Afif Limem and Yasmine Laabidi and Wassim Ben Chedly and Yassine Ouanes and Mokhtar Bibi and Mahdi Marrak and Ines Chelly and Mourad Hadj Slimene and Yassine Nouira},
  journal = {BMC urology},
  year = {2026},
  month = jul,
  doi = {10.1186/s12894-026-02282-3},
  url = {https://europepmc.org/article/MED/42907957},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Predicting acute kidney injury after radical cystectomy for muscle-invasive bladder cancer.
AU  - Kays Chaker
AU  - Ahmed Chaabouni
AU  - Wafa Elleuch
AU  - Aida Khadhar
AU  - Khouloud Ouertani
AU  - Ali Chakroun
AU  - Afif Limem
AU  - Yasmine Laabidi
AU  - Wassim Ben Chedly
AU  - Yassine Ouanes
AU  - Mokhtar Bibi
AU  - Mahdi Marrak
AU  - Ines Chelly
AU  - Mourad Hadj Slimene
AU  - Yassine Nouira
PY  - 2026
DA  - 2026/07/01
JO  - BMC urology
DO  - 10.1186/s12894-026-02282-3
UR  - https://europepmc.org/article/MED/42907957
AB  - Introduction  Radical cystectomy (RC) with urinary diversion remains the gold standard for the treatment of muscle invasive tumors. RC is a major surgery associated with a high morbidity rate. Postoperative acute kidney injury (AKI) is associated with severe morbidity and mortality. In this study we attempted to identify risk factors for postoperative AKI in patients undergoing RC.Patients and methods  A multicenter retrospective analysis was conducted among patients treated with radical cystectomy for muscle-invasive bladder cancer between 2015 and 2024. AKI was defined by Kidney Disease Improving Global Outcomes (KDIGO), within 90 days of surgery, with the occurrence of 1 of the 3 items: (1) increase in serum creatinine by ≥ 26.5 µmol/L within 48 h; (2) increase in serum creatinine ≥ 1.5-time baseline, which is known or presumed to have occurred within the prior seven days; (3) urine volume < 0.5 ml/kg/h during 6 h, KDIGO score were also recorded. Data were compared between two groups of patients: occurrence of AKI within the first 30 days of the post-operative period (AKI group) or no AKI during this period (no AKI group).Results  We included 520 patients. The incidence of postoperative AKI was 40.38% (n = 210). Patients with AKI were active smoker (p = 0.03), significantly less often anemic (p = 0.01), had a higher BMI (p = 0.002), preoperative anemia (p = 0.01). Duration of surgery was longer in AKI patients (p < 0.001). AKI patients were more likely to need vasoactive agents (p = 0.04). Independent factors associated with AKI were intraoperative blood loss (OR = 4.8 [95%CI: 3.06-6.43]; p = 0.01), duration of surgery (OR = 3.36 [95%CI: 2.9-11.19]; p = 0.0014); Preoperative anemia (OR = 2.69 [95%CI: 1.06-5.2]; p < 0.001); use of vasoactive agents (OR = 6.36, [95%CI: 6.01-36.87]; p < 0.001). Postoperative AKI was not associated with 2-year mortality (p = 0.71).Conclusion  A significant number of patients experienced AKI after RC. Recognizing pre- and perioperative risk factors can identify patients where close surveillance and early intervention may help minimize renal function decline following RC.
SN  - 1471-2490
ER  -