Metabolic bone disease following urinary diversion in adults
Abstract
PURPOSE OF REVIEW: Urinary diversions are created following radical cystectomy or for the palliation of recalcitrant lower urinary tract symptoms. Chronic metabolic acidosis, one of the several long-term complications associated with urinary diversion, has been shown to lead to metabolic bone disease if untreated.
RECENT FINDINGS: The incidence of chronic acidosis can be influenced by several factors, including type and length of bowel segment utilized, renal function, and type of urinary diversion. The observed rate of acidosis has been noted to be high, particularly in patients undergoing continent ileal neobladders using long bowel segments. Results from the five selected case series evaluating the association between urinary diversion and development of metabolic bone disease are inconsistent, but the majority report a low incidence of bone disease, ranging from 0 to 15%. In order to decrease the risk of developing metabolic bone disease and the other associated disorders, attention to the diagnosis of acidosis postoperatively, along with preventive therapy, is crucial. Treatment of acidosis secondary to urinary diversion may be accomplished in the long term with oral alkalizing agents.
SUMMARY: Although there is no clear relationship between urinary diversion and the future development of metabolic bone disease, diagnosis and treatment of postoperative acidosis are recommended.
Read the paper
Related studies
- Understanding the factors influencing fall armyworm (Spodoptera frugiperda J.E. Smith) damage in African smallholder maize fields and quantifying its impact on yield. A case study in Eastern Zimbabwe
- Alarming situation of emerging H5 and H7 avian influenza and effective control strategies
- Livestock and food security: vulnerability to population growth and climate change
- Atmosphere–ocean oxygen and productivity dynamics during early animal radiations
- Characterization of the global distribution and diversified plasmid reservoirs of the colistin resistance gene mcr-9
- The global seroprevalence of Toxoplasma gondii in pigs: A systematic review and meta-analysis
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.