Presentation Authors: Paolo Capogrosso*, Umberto Capitanio, Alessandro Larcher, Eugenio Ventimiglia, Walter Cazzaniga, Francesco Trevisani, Daniela Canibus, Cristina Carenzi, Franco Gaboardi, Roberto Bertini, Francesco Montorsi, Andrea Salonia, Milan, Italy
Introduction: Erectile dysfunction (ED) has been associated with a higher risk of developing cardiovascular diseases, metabolic disorders and other comorbidities. Patients surgically treated for renal cell carcinoma (RCC) are at risk of developing chronic kidney disease (CKD) over time. Detecting those at higher risk of CKD is crucial for an adequate treatment and follow-up planning. We tested the association between preoperative ED and the risk of developing CKD after surgery for RCC.
Methods: A total 106 male patients surgically treated for RCC at a single center, between 2012 and 2018, had available preoperative erectile function (EF) data. Preoperative EF was assessed with the International Index of Erectile Function-EF (IIEF-EF). This questionnaire is routinely administered at our center to RCC patients aged
Results: Median (IQR) preoperative IIEF-EF score was 26 (12-29), with 24% (N=22) of patients reporting scores suggestive for severe ED (IIEF-EF < 11). At baseline, 82 (91%) patients had normal eGFR. 55 (61%) patients were treated with RN. Median (IQR) follow-up was 27.5 (17-47) months. Overall, the estimated risk of postoperative CKD was 5% (95%CI: 2-15) and 21% (95%CI: 12-35) at 1- and 2-year after surgery. Patients with preoperative severe ED showed a higher risk (p=0.002) of developing postoperative CKD [1-year: 13% (95%CI: 4-44); 2-year: 44% (95%CI:22-73)] compared to others [1-year: 2%(95%CI: 0-15); 2-year: 13% (95%CI:6-29)]. At Cox regression analysis, preoperative severe ED was associated with higher risk of developing CKD after surgery (HR: 2.67; 95%CI: 1.03-6.94, p=0.04) after adjusting for type of treatment (RN vs. PN) and preoperative eGFR.
Conclusions: Erectile dysfunction is a common disorder among patients with RCC. Those with severe ED depicted 3-fold higher risk of developing postoperative CKD. Preoperative EF status may be an additional factor to be considered for treatment planning and follow-up of patients with RCC.