Review
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World J Nephrol. Nov 6, 2014; 3(4): 198-209
Published online Nov 6, 2014. doi: 10.5527/wjn.v3.i4.198
Prostatic surgery associated acute kidney injury
Elerson Carlos Costalonga, Verônica Torres Costa e Silva, Renato Caires, James Hung, Luis Yu, Emmanuel A Burdmann
Elerson Carlos Costalonga, Verônica Torres Costa e Silva, Renato Caires, James Hung, Luis Yu, Emmanuel A Burdmann, Department of Nephrology, Cancer Institute of São Paulo, University of São Paulo Medical School, São Paulo 01246-000, Brazil
Luis Yu, Emmanuel A Burdmann, Division of Nephrology, University of São Paulo Medical School, São Paulo 01246-903, Brazil
Author contributions: Costalonga EC, Costa e Silva VT, Caires R, Hung J, Yu L and Burdmann EA contributed equally to this work.
Correspondence to: Elerson Carlos Costalonga, MD, Department of Nephrology, Cancer Institute of Sao Paulo, University of Sao Paulo Medical School, Av Dr Arnaldo 251, 2o Andar (Porta 2), São Paulo 01246-000, SP, Brazil. elersonc@yahoo.com.br
Telephone: +55-11-38932332 Fax: +55-11-30882267
Received: May 28, 2014
Revised: August 7, 2014
Accepted: October 14, 2014
Published online: November 6, 2014
Processing time: 163 Days and 14.3 Hours
Abstract

Acute kidney injury (AKI) is associated with extended hospital stays, high risks of in-hospital and long-term mortality, and increased risk of incident and progressive chronic kidney disease. Patients with urological diseases are a high-risk group for AKI owing to the coexistence of obstructive uropathy, older age, and preexistent chronic kidney disease. Nonetheless, precise data on the incidence and outcomes of postoperative AKI in urological procedures are lacking. Benign prostatic hyperplasia and prostate cancer are common diagnoses in older men and are frequently treated with surgical procedures. Whereas severe AKI after prostate surgery in general appears to be unusual, AKI associated with transurethral resection of the prostate (TURP) syndrome and with rhabdomyolysis (RM) after radical prostatectomy have been frequently described. The purpose of this review is to discuss the current knowledge regarding the epidemiology, risk factors, outcomes, prevention, and treatment of AKI associated with prostatic surgery. The mechanisms of TURP syndrome and RM following prostatic surgeries will be emphasized.

Keywords: Acute kidney injury; Prostatic hyperplasia; Prostate cancer; Transurethral resection of the prostate; Prostatectomy; Rhabdomyolysis

Core tip: Postoperative acute kidney injury has a significant effect on patient outcomes and has been associated with longer hospital stays, high risks of in-hospital and long-term mortality. Urology patients are a high-risk group for acute kidney injury (AKI) because of the common occurrences of obstructive uropathy, older age, and chronic kidney disease, as well as postoperative complications. The purpose of this review is to discuss the current knowledge regarding the epidemiology, risk factors, outcomes, prevention, and treatment of AKI associated with prostatic surgery.