Factors Predicting Renal Function Outcome after Augmentation Cystoplasty

Abstract

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 was7.0±2.6years. Significant bladder capacity, end filling pressure, and bladder compliance were achieved from median114±53.6to342.1±68.3 ml (p=.0001),68.5±19.9to28.2±6.9 cm H2O (p=.0001), and3.0±2.1to12.8±3.9(p=.0001), respectively. Renal function remained stable and improved in 22 (76%) patients from median eGFR135±81.98to142.82±94.4 ml/min/1.73 m2(p=.160). Significant deterioration was found in 7 (24%) patients from median eGFR68.25±42to36.57±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.