The following is a summary of “Effect of Chronic Kidney Disease on Adverse In-Hospital Outcomes at Radical Prostatectomy,” published in the March 2025 issue of International Journal of Urology by Falkenbach et al. 

Researchers conducted a retrospective study on chronic kidney disease (CKD) impact on in-hospital outcomes after radical prostatectomy (RP) and found higher complication rates, emphasizing careful patient selection. 

They used descriptive analyses, propensity score matching (PSM), and multivariable logistic and Poisson regression models on National Inpatient Sample patients with RP (2005–2019). CKD severity was stratified as mild (stage I/II), moderate (stage III), and severe (stage IV/V). 

The results showed that of 191,050 patients with RP, 4,349 (2.3%) had CKD, with 2,301 (52.9%) mild, 1,416 (32.6%) moderate, and 632 (14.5%) severe. The CKD rate rose from 0.3% to 5.6% (2005–2019, EAPC: +15.3%, P < 0.001). Patients with CKD had higher adverse in-hospital outcomes, except mortality. Absolute differences were highest for complications (+12.5%), length of stay >2 days (+11.8%), and blood transfusions (+3.7%, all P < 0.001). CKD was an independent predictor in all but mortality (P < 0.05), with the strongest effects on dialysis (OR: 10.49), genitourinary complications (OR: 2.47), and critical care therapies (OR: 2.45, all P < 0.001). A dose–response effect of CKD severity on adverse outcomes was seen in 7 of 14 comparisons. 

Investigators had higher adverse in-hospital outcomes after RP, highlighting the need for careful consideration of CKD in treatment decisions. 

Source: onlinelibrary.wiley.com/doi/10.1111/iju.70038