Transient renal dysfunction due to rhabdomyolysis after robot-assisted radical prostatectomy.

Abstract

PURPOSE:

The aim of the present study was to investigate whether renal dysfunction following rhabdomyolysis occurs after robot-assisted radical prostatectomy (RARP), and to investigate the factors related to rhabdomyolysis after RARP.

METHODS:

A total of 180 consecutive patients who underwent RARP at our institution were investigated. Rhabdomyolysis was defined as creatine kinase (CK) > 1050 IU/L after RARP. The association between CK and renal function after RARP was investigated, and the factors related to rhabdomyolysis after RARP were also investigated.

RESULTS:

Postoperative CK (407 ± 936 IU/L) was significantly higher than preoperative CK (134 ± 75 IU/L) (p < 0.001), and eGFR after RARP was significantly negatively correlated with CK on the day after RARP (correlation coefficient (ρ) = - 0.248, p = 0.007), but the significant negative correlation disappeared on the 7th day after RARP (ρ = - 0.010, p = 0.32). On multivariate analysis, postoperative CK elevation was significantly correlated with console time (p = 0.002). Rhabdomyolysis was observed in 6.1% (11/180), and of the patients with rhabdomyolysis, acute renal failure was transiently observed in 45.5% (5/11). On multivariate analysis, rhabdomyolysis was significantly associated with higher body mass index (BMI) (> 25.7 kg/m2) and longer console time (> 188 min) (p = 0.02 and p = 0.005, respectively).

CONCLUSION:

Temporary renal dysfunction can occur after RARP due to CK elevation. Thus, sufficient attention must be paid to renal insufficiency after elevation of CK values for several days after RARP. Because rhabdomyolysis after RARP was associated with both obesity and long console time, console time during RARP should be shortened, especially in patients with obesity.

• Authors: Akifumi Onagi, Nobuhiro Haga, Ryo Tanji, Ruriko Honda, Kanako Matsuoka, Seiji Hoshi, Tomoyuki Koguchi, Jyunya Hata, Yuichi Sato, Hidenori Akaihata, Masao Kataoka, Soichiro Ogawa, Yoshiyuki Kojima
• Journal: International urology and nephrology (Int Urol Nephrol) Vol. 52 Issue 10 Pg. 1877-1884 (Oct 2020) ISSN: 1573-2584 [Electronic] Netherlands
• PMID: 32451781 (Publication Type: Journal Article)

Topics

• Aged
• Humans
• Kidney (physiopathology)
• Kidney Diseases (etiology, physiopathology)
• Male
• Middle Aged
• Prostatectomy (adverse effects, methods)
• Retrospective Studies
• Rhabdomyolysis (complications, etiology, physiopathology)
• Robotic Surgical Procedures (adverse effects)
• Time Factors