MP61-03 RENAL FUNCTIONAL ASSESSMENT IN PATIENTS WITH URINARY DIVERSION: WHICH MODALITY FOR WHICH PATIENT?

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion II (MP61)1 Apr 2019MP61-03 RENAL FUNCTIONAL ASSESSMENT IN PATIENTS WITH URINARY DIVERSION: WHICH MODALITY FOR WHICH PATIENT? Nabil El-Ashry, Ahmed Harraz*, Mohamed Zahran, Hossam Nabeeh, Rasha Abouelkheir, Mohamed El-Ghar, Ahmed Mosbah, and Hassan Abol-Enein Nabil El-AshryNabil El-Ashry More articles by this author , Ahmed Harraz*Ahmed Harraz* More articles by this author , Mohamed ZahranMohamed Zahran More articles by this author , Hossam NabeehHossam Nabeeh More articles by this author , Rasha AbouelkheirRasha Abouelkheir More articles by this author , Mohamed El-GharMohamed El-Ghar More articles by this author , Ahmed MosbahAhmed Mosbah More articles by this author , and Hassan Abol-EneinHassan Abol-Enein More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556805.28286.afAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: To prospectively assess the accuracy of different modalities of renal function assessment in patients with urinary diversion. METHODS: A prospective study was conducted for patients underwent radical cystectomy and urinary diversion attending the scheduled follow-up in a tertiary referral center. Inclusion criteria involved patients with orthotopic ileal w neobladder (ONB) or ileal conduit (IC) urinary diversion with surveillance ultrasonography revealing no hydronephrosis and serum creatinine level below 1.2 mg/dl. Only patients with a minimum of one year follow-up were included and those with no evidence of disease failure. The first 30 patients fulfilling the inclusion criteria were enrolled. A control group (C) with normal renal function were invited. The study received the institutional review board approval. Patients were consented for undergoing renal functional assessment modalities including, the estimated glomerular filtration rate using the modification of diet in renal disease equation (MDRD), chronic kidney disease epidemiology collaboration equation (CKD-EPI), 99-mTc mercaptoacetyltriglycine (MAG3) diuretic scintigraphy (MAG-GFR), and dynamic magnetic resonance imaging (dynamic-GFR). All tools were compared with creatinine clearance (CrCl) measured by 24-hour urinary collection. RESULTS: 30 patients in each group were enrolled. The median (range) follow-up after urinary diversion was 79 (15-256) months. There was no significant difference between the values of MDRD and CKD-EPI across groups as well as MAG3-GFR and Dynamic-GFR. In IC, assessment tools were not significantly different from CrCl. Conversely, there was a significant overestimation of renal function in ONB where the highest values were for MAG-GFR and dynamic-GFR. Regarding C, MAG-GFR and Dynamic-GFR significantly overestimated CrCl compared to equations where albeit of lower values, were more close to represent CrCl. The results are demonstrated in the table 1 and figure 1. CONCLUSIONS: The performance of the renal function assessment tools was not homogenous among the study groups. In patients with ONB, none of the assessed measures was precise enough to predict renal function unlike in patients with IC. Source of Funding: None Mansoura, Egypt; Kafr El-Sheikh, Egypt; Mansoura, Egypt© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e878-e878 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nabil El-Ashry More articles by this author Ahmed Harraz* More articles by this author Mohamed Zahran More articles by this author Hossam Nabeeh More articles by this author Rasha Abouelkheir More articles by this author Mohamed El-Ghar More articles by this author Ahmed Mosbah More articles by this author Hassan Abol-Enein More articles by this author Expand All Advertisement PDF downloadLoading ...