{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:44:01Z","timestamp":1789656241447,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T00:00:00Z","timestamp":1733875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2025,3]]},"abstract":"\n Objective<\/jats:title>\n To investigate the prevalence, predictors and impact of surgically induced chronic kidney disease (CKD\u2010S) on survival outcomes in patients with upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Utilising the ROBUUST 2.0 registry, a multicentre retrospective analysis was conducted in patients with UTUC undergoing RNU between 2006 and 2022 who did not have baseline chronic kidney disease (CKD) stages 3\u20135. We calculated the prevalence of postoperative CKD\u2010S3a (estimated glomerular filtration rate [eGFR] 59\u201345\u2009mL\/min\/1.73\u2009m\n 2<\/jats:sup>\n ) and CKD\u2010S3b (eGFR <45\u2009mL\/min\/1.73\u2009m\n 2<\/jats:sup>\n ) as measured by the Chronic Kidney Disease Epidemiology Collaboration 2021 equation. The analytical cohort was stratified by postoperative CKD stage [no CKD\u2010S [eGFR \u226560\u2009mL\/min\/1.73\u2009m\n 2<\/jats:sup>\n ]; CKD\u2010S3a [eGFR 59\u201345\u2009mL\/min\/1.73\u2009m\n 2<\/jats:sup>\n ] and CKD\u2010S3b [eGFR <45\u2009mL\/min\/1.73\u2009m\n 2<\/jats:sup>\n ]). The primary outcome was all\u2010cause mortality (ACM). Predictors for development of CKD\u2010S3a\/3b and ACM\/cancer\u2010specific mortality (CSM) were analysed using logistic and Cox regression, respectively. Kaplan\u2013Meier analysis was used to analyse overall survival (OS) and cancer\u2010specific survival (CSS) among postoperative CKD groups.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We analysed 1862 patients; 34.7% (646) and 39.6% (738), respectively, developed CKD\u2010S3a and CKD\u2010S3b. Predictors of CKD\u2010S3b included increasing age (odds ratio [OR]\u20091.03,\n P<\/jats:italic>\n \u2009=\u20090.029), decreasing preoperative eGFR (OR\u20091.06,\n P<\/jats:italic>\n \u2009<\u20090.001) and receipt of neoadjuvant (OR\u20092.07,\n P<\/jats:italic>\n \u2009=\u20090.006) and adjuvant chemotherapy (OR\u20091.41,\n P<\/jats:italic>\n \u2009=\u20090.012). Worsened ACM was associated with CKD\u2010S3b (hazard ratio\u20091.42,\n P<\/jats:italic>\n \u2009=\u20090.032), but not CKD\u2010S3a (\n P<\/jats:italic>\n \u2009=\u20090.766). Development of CKD\u2010S3a (\n P<\/jats:italic>\n \u2009=\u20090.812) and CKD\u2010S3b (\n P<\/jats:italic>\n \u2009=\u20090.316) were not associated with CSM. The 5\u2010year OS rate was significantly worse in CKD\u2010S3b (no\u2010CKD 71%, CKD\u2010S3a 70%, CKD\u2010S3b 59%;\n P<\/jats:italic>\n \u2009=\u20090.017). No differences between CKD\u2010S groups were noted for 5\u2010year CSS (no\u2010CKD 78%, CKD\u2010S3a 77%, CKD\u2010S3b 82%;\n P<\/jats:italic>\n \u2009=\u20090.44).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A significant proportion of UTUC patients undergoing RNU developed CKD\u2010S. Development of CKD\u2010S3b was associated with worse ACM. Increasing age, preoperative eGFR, and chemotherapy were associated with developing CKD\u2010S3b. Our findings call for further exploration and refinement of nephron\u2010preserving surgical strategies and non\u2010nephrotoxic systemic therapy to improve survival outcomes in UTUC.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.16569","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:24:04Z","timestamp":1733963044000},"page":"481-488","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The impact of post\u2010nephroureterectomy surgically induced chronic kidney disease on survival outcomes"],"prefix":"10.1111","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6657-0135","authenticated-orcid":false,"given":"Dhruv","family":"Puri","sequence":"first","affiliation":[{"name":"Department of Urology UC San Diego School of Medicine La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret F.","family":"Meagher","sequence":"additional","affiliation":[{"name":"Department of Urology UC San Diego School of Medicine La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6487-5207","authenticated-orcid":false,"given":"Zhenjie","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Urology, Changhai Hospital Naval Medical University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Franco","sequence":"additional","affiliation":[{"name":"Department of Urology Rush University Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4056-0462","authenticated-orcid":false,"given":"Linhui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology, Changhai Hospital Naval Medical University Shanghai 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