Preoperative renal scar as a risk factor of postoperative metabolic acidosis following ileocystoplasty in patients with neurogenic bladder

Mitsui, Takahiko; Moriya, Kimihiko; Kitta, Takeya; Kon, Masafumi; Nonomura, Katsuya

Preoperative renal scar as a risk factor of postoperative metabolic acidosis following ileocystoplasty in patients with neurogenic bladder

Mitsui, Takahiko; Moriya, Kimihiko; Kitta, Takeya et al.

Spinal Cord, 2014, 52(4), 292-294

Permalink : https://hdl.handle.net/2115/57015

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アクセス権	open access
URI	https://hdl.handle.net/2115/57015
タイトル	Preoperative renal scar as a risk factor of postoperative metabolic acidosis following ileocystoplasty in patients with neurogenic bladder
著者	Mitsui, Takahiko ; Moriya, Kimihiko ; Kitta, Takeya ; Kon, Masafumi ; Nonomura, Katsuya
e-Rad_Researcher 90421966 著者名 Mitsui, Takahiko
e-Rad_Researcher 20374233 著者名 Moriya, Kimihiko
e-Rad_Researcher 40374441 著者名 Kitta, Takeya
著者名 Kon, Masafumi
e-Rad_Researcher 60113750 著者名 Nonomura, Katsuya
言語	英語
キーワード	metabolic acidosis
	base excess
	renal scar
	augmentation
	bowel
	neurogenic bladder
発行日	2014-04
出版者	Nature Publishing Group
収録物名	Spinal Cord
巻(号)	52(4)
ページ	292-294
抄録	Objectives: We investigated relation of preoperative renal scar to incidence of postoperative metabolic acidosis following ileocystoplasty in patients with neurogenic bladder. Patients: Thirty patients with neurogenic bladder, who underwent ileocystoplasty, were enrolled in the present study. Median age at ileocystoplasty was 13.9 years and median follow-up period after ileocystoplasty was 8.2 years. Metabolic acidosis was defined based on the outlined criteria: base excess (BE) is less than 0 mmol l (-1). Preoperative examination revealed that no apparent renal insufficiency was identified in blood analysis, although preoperative Tc-99m-DMSA scintigraphy indicated abnormalities such as renal scar in 14 patients (47%). Incidence of postoperative metabolic acidosis was compared between patients with and without preoperative renal scar, which may reflect some extent of renal tubular damage. Results: Postoperative metabolic acidosis was identified in 13 patients (43%). Incidence of postoperative metabolic acidosis was significantly higher in patients with renal scar (11/14, 79%) compared with patients without renal scar (2/16, 13%; P<0.01). Particularly, all eight patients who had bilateral renal scars showed metabolic acidosis postoperatively. Compared with patients without preoperative renal scar, pH (P<0.05) and BE (P<0.01) were significantly lower postoperatively in patients with preoperative renal scar. However, there was no significant difference in PCO2. Hyperchloremia was observed in each patient with or without preoperative renal scar. Conclusion: Incidence of postoperative metabolic acidosis was significantly implicated in preoperative renal scar. If renal abnormalities are preoperatively identified in imaging tests, we need to care patients carefully regarding metabolic acidosis and subsequent comorbidities following ileocystoplasty.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
PISSN	1362-4393
EISSN	1476-5624
NCID	AA11084799
関連情報	PMID 24469144
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1038/sc.2013.175