Vejlgaard M, Maibom SL, Stroomberg HV, et al. - Among bladder cancer patients who underwent radical cystectomy (RC), a considerable reduction of long-term renal function occurred postoperatively in a large number of patients. To minimize renal insufficiency post-RC, a requisite step is to recognize preoperative risk factors in order to identify cases that benefit from enhanced renal surveillance or early intervention for modifiable factors.

• A total of 670 patients who had RC at a single center in Denmark between 2009 and 2019 were analyzed [median follow-up was 6.2 years (interquartile range 4.0-8.4)].

• Increment in the proportion of patients with renal insufficiency [estimated glomerular filtration rate (eGFR) <45 mL/min] was evident, from 8.9% prior to RC to 19% five years post-surgery.

• At 5 years after surgery, the absolute risk of renal function decline to chronic kidney disease stage G3b or worse (eGFR<45 mL/min) was reported to be 17% (95% CI 14-20).

• There was no significant association between loss of renal function and higher all-cause mortality.

• Factors that were independently linked with renal function decline were: lower preoperative eGFR, diabetes mellitus, prior pelvic radiation therapy, continent urinary diversion types, and postoperative ureteral stricture.