Dados do Resumo

Título

Chronic Kidney Disease after Cancer Cystectomy: An Integrative Review

Introdução

Cystectomy for bladder cancer involves the total or partial removal of the urinary bladder and is associated with relevant postoperative complications, such as chronic kidney disease (CKD). The deterioration of renal function, observed in patients with CKD, is an adverse event with a negative impact on the postoperative prognosis. Due to the severity of the clinical condition, follow-up is essential for the proper management of these patients.

Objetivo

To conduct an integrative review on the development of CKD in patients undergoing cancer cystectomy, identifying risk factors, mechanisms involved, and management strategies.

Métodos

An integrative literature review was carried out, with data collected on the PubMed platform. The descriptors taken from DeCS and MeSH were used: "Urinary Bladder Neoplasms", "Cystectomy" and "Chronic Renal Insufficiency", and studies published in the last 10 years (2014-2024) were included, resulting in 11 studies. Among these, 8 studies were considered more pertinent to the theme and used as reference.

Resultados

The integrative literature analysis indicates that patients with more severe CKD are generally elderly and have more comorbidities, which is associated with a worse prognosis, more hospital admissions, and a greater need for transfusions. After six months of surgery, there is a significant decline in kidney function. Patients with neobladder or ileal conduit have a progressive reduction in glomerular filtration rate over five years. Factors such as advanced stage of CKD, metastases, and lymphovascular invasion are associated with worse mortality rates and cancer progression. The duration of dialysis was longer in patients who underwent immediate cystectomy, although without statistical significance. In addition, 7.2% of patients develop end-stage CKD, with a higher risk in cases of ileal conduit.

Conclusões

We conclude that progression to CKD was identified in some of the patients analyzed, highlighting the need for accurate follow-up, as well as effective approaches to improve postoperative outcomes

Palavras Chave

Urinary Bladder Neoplasms; Cystectomy; Chronic Renal Insufficiency