Factors Predicting Renal Function Outcome after Augmentation Cystoplasty

الملخص EN

We determined the cause of renal deterioration after augmentation cystoplasty (AC).

Twenty-nine adult patients with refractory bladder dysfunction and who underwent ileocystoplasty from 2004 to 2015 were studied.

Patients with a decline in glomerular filtration rate (GFR) after augmentation were reviewed.

The primary outcome was to determine the factors that might lead to deterioration of estimated GFR.

Median follow-up was 7.0±2.6 years.

Significant bladder capacity, end filling pressure, and bladder compliance were achieved from median 114±53.6 to 342.1±68.3 ml (p=.0001), 68.5±19.9 to 28.2±6.9 cm H2O (p=.0001), and 3.0±2.1 to 12.8±3.9 (p=.0001), respectively.

Renal function remained stable and improved in 22 (76%) patients from median eGFR 135±81.98 to 142.82±94.4 ml/min/1.73 m2 (p=.160).

Significant deterioration was found in 7 (24%) patients from median eGFR 68.25±42 to 36.57±35.33 (p=.001).

The causes of renal deterioration were noncompliance to self-catheterization (2 patients), posterior urethral valve/dysplastic kidneys (2 patients), and reflux/infection (2 patients).

On multivariate analysis, recurrent pyelonephritis (OR 3.87, p=0.0155) and noncompliance (OR 30.78, p=0.0156) were significant.

We concluded that AC is not the cause of progression to end-stage renal disease in patients with renal insufficiency.