International journal of urology : official journal of the Japanese Urological Association · 2025
The Effect of Chronic Kidney Disease on Adverse In-Hospital Outcomes at Radical Prostatectomy.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Falkenbach Fabian, Peñaranda Natali Rodriguez, Longoni Mattia, Marmiroli Andrea, Le Quynh Chi, Catanzaro Calogero, Nicolazzini Michele, Tian Zhe, Goyal Jordan A, Puliatti Stefano, Schiavina Riccardo, Palumbo Carlotta, Musi Gennaro, Chun Felix K H, Briganti Alberto, Saad Fred, Shariat Shahrokh F, Budäus Lars, Graefen Markus, Karakiewicz Pierre I
Аннотация
OBJECTIVE: Radical prostatectomy (RP) may be a treatment option for prostate cancer in patients with chronic kidney disease (CKD). However, the effect of CKD on adverse in-hospital outcomes after RP is not well known.
METHODS: Descriptive analyses, propensity score matching (PSM), and multivariable logistic and Poisson regression models were used to address National Inpatient Sample RP patients between 2005 and 2019. CKD severity was stratified as mild (stage I/II) versus moderate (stage III) versus severe (stage IV/V).
RESULTS: Of 191 050 RP patients, 4349 (2.3%) had CKD. Of those, 2301 (52.9%), 1416 (32.6%), and 632 (14.5%) were classified as mild, moderate, or severe CKD, respectively. The CKD rate increased from 0.3% to 5.6% (2005-2019, EAPC: + 15.3%, p < 0.001). CKD patients invariably exhibited higher rates of adverse in-hospital outcomes, except for in-hospital mortality. The absolute differences were largest for overall complications (+ 12.5%), length of stay > 2 days (+ 11.8%), and blood transfusions (+ 3.7%, all p < 0.001). CKD was an independent predictor in all comparisons except for in-hospital mortality (p < 0.05). The detrimental effect was most pronounced for dialysis for acute kidney failure (multivariable odds ratio [OR] 10.49), genitourinary complications (OR: 2.47), and critical care therapies (OR: 2.45, all p < 0.001). Finally, a dose-response relationship of CKD severity (mild vs. moderate vs. severe) and its effect on adverse in-hospital outcomes was observed in seven of 14 comparisons.
CONCLUSIONS: CKD patients invariably exhibited higher rates of adverse in-hospital outcomes after RP. The presence of CKD should be carefully considered when RP represents a management option.
METHODS: Descriptive analyses, propensity score matching (PSM), and multivariable logistic and Poisson regression models were used to address National Inpatient Sample RP patients between 2005 and 2019. CKD severity was stratified as mild (stage I/II) versus moderate (stage III) versus severe (stage IV/V).
RESULTS: Of 191 050 RP patients, 4349 (2.3%) had CKD. Of those, 2301 (52.9%), 1416 (32.6%), and 632 (14.5%) were classified as mild, moderate, or severe CKD, respectively. The CKD rate increased from 0.3% to 5.6% (2005-2019, EAPC: + 15.3%, p < 0.001). CKD patients invariably exhibited higher rates of adverse in-hospital outcomes, except for in-hospital mortality. The absolute differences were largest for overall complications (+ 12.5%), length of stay > 2 days (+ 11.8%), and blood transfusions (+ 3.7%, all p < 0.001). CKD was an independent predictor in all comparisons except for in-hospital mortality (p < 0.05). The detrimental effect was most pronounced for dialysis for acute kidney failure (multivariable odds ratio [OR] 10.49), genitourinary complications (OR: 2.47), and critical care therapies (OR: 2.45, all p < 0.001). Finally, a dose-response relationship of CKD severity (mild vs. moderate vs. severe) and its effect on adverse in-hospital outcomes was observed in seven of 14 comparisons.
CONCLUSIONS: CKD patients invariably exhibited higher rates of adverse in-hospital outcomes after RP. The presence of CKD should be carefully considered when RP represents a management option.