Department of Urology, Capital Medical University Beijing Friendship Hospital, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China.
Beijing Key Laboratory of Tolerance Induction and Organ Protection in Transplantation, No.95 Yong'an Road, Xicheng District, Beijing, 100050, China.
BMC Nephrol. 2019 Jul 23;20(1):278. doi: 10.1186/s12882-019-1455-2.
Chronic kidney disease (CKD) and end stage renal disease (ESRD) are not well characterized in prostate cancer patients. This study aimed to examine the clinical characteristics and postsurgical outcomes of patients with or without CKD and ESRD undergoing radical prostatectomy for prostate cancer.
This population-based, retrospective study used patient data from the Nationwide Inpatient Sample, the largest all-payer US inpatient care database. From 2005 to 2014, 136,790 male patients aged > 20 years diagnosed with prostate cancer and who received radical prostatectomy were included. Postoperative complications, postoperative acute kidney injury (AKI) and urinary complications, and length of hospital stay were compared between patients with or without underlying CKD and ESRD.
After adjusting for relevant factors, the CKD group had a significantly higher risk of postoperative complications than the non-CKD group. In addition, the CKD group had a 5-times greater risk of postoperative AKI and urinary complications than the non-CKD group. Both CKD and ESRD groups had significantly longer hospital stays than the non-CKD group. Patients receiving RARP had a lower risk of postoperative complications than those who received open radical prostatectomy, regardless of having CKD or not. Both non-CKD and CKD patients receiving RARP had shorter hospital stays than those who received open surgery.
Prostate cancer patients with underlying CKD had significantly greater risk of postoperative complications, postoperative AKI and urinary complications, and longer hospital stays than those without CKD. The use of RARP significantly shortened hospital stays and reduced complications for these patients.
慢性肾脏病（CKD）和终末期肾病（ESRD）在前列腺癌患者中表现不佳。本研究旨在检查患有或不患有 CKD 和 ESRD 的前列腺癌患者接受根治性前列腺切除术的临床特征和术后结果。
这项基于人群的回顾性研究使用了来自全美住院患者样本（美国最大的所有支付者住院护理数据库）的患者数据。2005 年至 2014 年期间，共有 136790 名年龄>20 岁、诊断为前列腺癌并接受根治性前列腺切除术的男性患者纳入本研究。比较了伴有或不伴有基础 CKD 和 ESRD 的患者之间的术后并发症、术后急性肾损伤（AKI）和尿并发症以及住院时间。
在调整了相关因素后，CKD 组的术后并发症风险明显高于非 CKD 组。此外，CKD 组术后 AKI 和尿并发症的风险比非 CKD 组高 5 倍。CKD 组和 ESRD 组的住院时间均明显长于非 CKD 组。与接受开放性根治性前列腺切除术的患者相比，接受机器人辅助前列腺切除术（RARP）的患者术后并发症的风险更低，无论是否患有 CKD。接受 RARP 的非 CKD 和 CKD 患者的住院时间均短于接受开放性手术的患者。
患有基础 CKD 的前列腺癌患者的术后并发症、术后 AKI 和尿并发症风险以及住院时间明显长于无 CKD 的患者。对于这些患者，RARP 的使用显著缩短了住院时间并减少了并发症。
