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Risk Factors for Developing Metabolic Acidosis after Radical Cystectomy and Ileal Neobladder

Title
Risk Factors for Developing Metabolic Acidosis after Radical Cystectomy and Ileal Neobladder
Authors
Kim, Kwang HyunYoon, Hyun SukYoon, HanaChung, Woo SikSim, Bong SukRyu, Dong-RyeolLee, Dong Hyeon
Ewha Authors
심봉석정우식이동현윤하나류동열김광현윤현석
SCOPUS Author ID
심봉석scopus; 정우식scopus; 이동현scopus; 윤하나scopus; 류동열scopus; 김광현scopus; 윤현석scopus
Issue Date
2016
Journal Title
PLOS ONE
ISSN
1932-6203JCR Link
Citation
vol. 11, no. 7
Publisher
PUBLIC LIBRARY SCIENCE
Indexed
SCIE; SCOPUS WOS scopus
Abstract
Purpose To investigate the serial changes of metabolic acidosis and identify associated risk factors in patients who underwent radical cystectomy and ileal neobladder. Material and Methods From January 2010 to August 2014, 123 patients who underwent radical cystectomy and ileal neobladder reconstruction for bladder cancer were included in this study. Metabolic acidosis was defined as a serum bicarbonate level less than 22 mEq/L and impaired renal function was defined as a GFR <50ml/min. The presence of metabolic acidosis was evaluated at 1 month, 1 year, and 2 years after surgery. Multivariate logistic regression analysis was conducted to identify risk factors associated with development of metabolic acidosis. Results Metabolic acidosis was observed in 52%, 19.5%, and 7.3% of patients at 1 month, 1 year, and 2 years after surgery, respectively. At 1 month after surgery, impaired renal function was the only independent risk factor associated with metabolic acidosis (OR 3.87, P = 0.046). At 1 year after surgery, diabetes was the only independent risk factor associated with metabolic acidosis (OR 5.68, P = 0.002). At 2 years post-surgery, both age and diabetes were significant risk factors associated with metabolic acidosis. Conclusion Approximately, half of patients experienced metabolic acidosis one month after ileal neobladder reconstruction. Preoperative impaired renal function was the most significant risk factor for developing metabolic acidosis in the early postoperative period. However, the incidence of metabolic acidosis decreased to less than 20% 1 year after surgery, and diabetes was an independent risk factor during this period.
DOI
10.1371/journal.pone.0158220
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의학전문대학원 > 의학과 > Journal papers
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