A temporary loop ileostomy affects renal function

• Published in: International journal of colorectal disease Vol. 29; no. 9; pp. 1131 - 1135
• Main Authors: Gessler, Bodil, Haglind, Eva, Angenete, Eva
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2014; Springer; Springer Nature B.V
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Antihypertensive Agents - therapeutic use; Colonic Diseases - surgery; Colorectal cancer; Colorectal Neoplasms - surgery; Creatinine - blood; Female; Gastroenterology; Gastrointestinal diseases; Glomerular Filtration Rate; Hepatology; Humans; Hypertension - complications; Hypertension - drug therapy; Ileostomy - adverse effects; Internal Medicine; Kidney - physiopathology; Kidney diseases; Kirurgi; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Proctology; Rectal Diseases - surgery; Reoperation; Retrospective Studies; Risk Factors; Surgery; Time Factors; Young Adult; Colorectal/anal neoplasia; Renal impairment; Loop ileostomy; Morbidity; Benign colorectal disease
• ISSN: 0179-1958; 1432-1262; 1432-1262
• DOI: 10.1007/s00384-014-1949-0

Purpose The purpose of this study was to evaluate renal morbidity after a temporary loop ileostomy and to identify possible preoperative risk factors. Method Consecutive patients at four hospitals serving 1,520,000 inhabitants who received a temporary loop ileostomy and underwent subsequent closure were identified and retrospectively studied from 1 January 2007 until 28 February 2010. Serum creatinine levels were obtained 1 week before index surgery and 1 week before closure of the loop ileostomy. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI formula. Results Three hundred eight patients with median age of 64 were identified. The indication for the loop ileostomy was colorectal cancer (226), inflammatory bowel disease (41), diverticulosis (8), and other conditions (33). Median time until closure was 161 days (3–873). There was a decrease in eGFR at time of closure (89 vs. 83; p  < 0.0001), and the number of patients with renal impairment (eGFR <60) increased (7.5 vs. 21 %, p  < 0.0001). Preoperative risk factors for eGFR <60 at closure were age and hypertension. Conclusions This study found that a loop ileostomy is associated with a reduced renal function for most patients, especially for older and hypertensive patients. This should be considered before constructing a loop ileostomy, and perhaps another stoma should be chosen if possible in patients at risk. Evaluation of medications before discharge and early and frequent postoperative follow-up could also reduce the risk of a reduced renal function.