Early renal dysfunction after temporary ileostomy construction

• Published in: Surgery today (Tokyo, Japan) Vol. 50; no. 7; pp. 703 - 710
• Main Authors: Yaegashi, Mizunori, Otsuka, Koki, Kimura, Toshimoto, Matsuo, Teppei, Fujii, Hitoshi, Sato, Kei, Takashimizu, Kiyoharu, Hatanaka, Tomoki, Yoshida, Toru, Tono, Chihiro, Sasaki, Akira
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.07.2020
• Subjects: Medicine; Medicine & Public Health; Original Article; Surgery; Surgical Oncology; Ileostomy; Complication; Renal impairment; Colorectal cancer; Glomerular filtration rate
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-019-01938-y

Purpose Loop ileostomy is often used to prevent complications after colorectal surgery, but it has been reported to cause renal impairment. This study aimed to evaluate the changes in the renal function after ileostomy and to compare these with the renal function after low anterior resection without ileostomy (low-ANT). Methods The subjects included 58 patients who underwent ileostomy construction and closure for rectal cancer. The estimated glomerular filtration rate (eGFR) was calculated at specific time points after the index surgery. In addition, we conducted a case-matched study on 147 patients who underwent low-ANT. Results The eGFR was significantly lower at 1 month after ileostomy than at the time of ileostomy construction (78.8 vs. 84.0, p  < 0.0001) and did not improve after ileostomy closure. The only risk factor for a reduced eGFR was preoperative chemotherapy or chemoradiotherapy. In the case-matched study, 36 patients were allocated for each of the two groups. The number of ileostomy patients with a reduced eGFR was significantly increased 1 month after the index surgery ( p  = 0.005). Conclusions The eGFR began to decrease at one month after ileostomy construction and did not improve after ileostomy closure.