Deterioration in renal function after stoma creation: a retrospective review from a Middle Eastern tertiary care center
BACKGROUND: Stomas are associated with multiple complications including dehydration which ultimately affects renal function. These complications begin with changes in the estimated glomerular filtration rate (GFR). OBJECTIVES: Evaluate changes in GFR after stoma creation by stoma type and identify h...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
King Faisal Specialist Hospital and Research Centre
2023-03-01
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| Series: | Annals of Saudi Medicine |
| Online Access: | http://www.annsaudimed.net/doi/10.5144/0256-4947.2023.76 |
| _version_ | 1797850258451988480 |
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| author | Shimaa Saad Al Khaldi Reem Al Harbi Sara Albastaki Neamat Al Turki Luai Ashari Khuloud Alhassan Alaa Abduljabbar Denise Hibbert Asim Almughamsi Samar Al Homoud Nasser Alsanea |
| author_facet | Shimaa Saad Al Khaldi Reem Al Harbi Sara Albastaki Neamat Al Turki Luai Ashari Khuloud Alhassan Alaa Abduljabbar Denise Hibbert Asim Almughamsi Samar Al Homoud Nasser Alsanea |
| author_sort | Shimaa Saad Al Khaldi |
| collection | DOAJ |
| description | BACKGROUND: Stomas are associated with multiple complications including dehydration which ultimately affects renal function. These complications begin with changes in the estimated glomerular filtration rate (GFR). OBJECTIVES: Evaluate changes in GFR after stoma creation by stoma type and identify how different types of stoma affect GFR. DESIGN: Retrospective, analytical cohort SETTING: Tertiary care center in Saudi Arabia PATIENTS AND METHODS: The colorectal surgery database was reviewed for all adult patients who underwent stoma creation (permanent and temporary ileostomies and colostomies) or reversal in 2000–2015. GFR was estimated at the first encounter, before the index surgery, at the time of stoma reversal, and upon the last follow-up. Patients with renal impairment, including low GFR before stoma creation, patients who had a temporary stoma converted to a permanent stoma, and patients who died with a stoma were excluded. We studied the association of several demographic and clinical factors on changes in GFR by univariate and multivariate analysis. MAIN OUTCOME MEASURES: Estimated GFR at the last clinic visit for the permanent stoma group and at stoma closure for the temporary stoma group. SAMPLE SIZE: 394 patients (149 ileostomates, 245 colostomates) RESULTS: Thirty-three (8.4%) of the 394 patients had a low GFR: 11 (7.4%) in the ileostomy group and 22 (9%) in the colostomy group (P= .579). The rate of readmissions with ileostomies was higher (11.4%) than with colostomies (3.3%) (P≤.001). The number of temporary ileostomies (n=9, 7.0%) differed from temporary colostomies (n=2, 1.9%) but the difference was not statistically significant (P=.06). In the multivariate analysis, stoma permanency, hypertension, chemotherapy and nephrotoxic drugs were risk factors associated with low GFR. CONCLUSION: Ileostomies were not associated with a high rate of renal function deterioration in comparison to colostomies, but had a significantly higher rate of readmission due to dehydration and electrolytes imbalance possibly due to the hot climate in Saudi Arabia. LIMITATIONS: Retrospective nature and limited sample size which may have resulted in a type 2 statistical error. CONFLICTS OF INTEREST: None. |
| first_indexed | 2024-04-09T18:57:28Z |
| format | Article |
| id | doaj.art-c3bd8dd4496b46a4998e43ea21ec0e1d |
| institution | Directory Open Access Journal |
| issn | 0256-4947 0975-4466 |
| language | English |
| last_indexed | 2024-04-09T18:57:28Z |
| publishDate | 2023-03-01 |
| publisher | King Faisal Specialist Hospital and Research Centre |
| record_format | Article |
| series | Annals of Saudi Medicine |
| spelling | doaj.art-c3bd8dd4496b46a4998e43ea21ec0e1d2023-04-09T09:21:43ZengKing Faisal Specialist Hospital and Research CentreAnnals of Saudi Medicine0256-49470975-44662023-03-01432768110.5144/0256-4947.2023.76Deterioration in renal function after stoma creation: a retrospective review from a Middle Eastern tertiary care centerShimaa Saad Al Khaldi0Reem Al Harbi1Sara Albastaki2Neamat Al Turki3Luai Ashari4Khuloud Alhassan5Alaa Abduljabbar6Denise Hibbert7Asim Almughamsi8Samar Al Homoud9Nasser Alsanea10From the Section of Colorectal Surgery, Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi ArabiaFrom the Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi ArabiaFrom the Department of Colorectal Surgery, Sheikh Khalifa Medical City, Abu Dhabi, United Arab EmiratesFrom the Section of Colorectal Surgery, Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi ArabiaFrom the Section of Colorectal Surgery, Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi ArabiaFrom the Section of Colorectal Surgery, Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi ArabiaFrom the Section of Colorectal Surgery, Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi ArabiaFrom the Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi ArabiaFrom the College of Medicine, Taibah University, Madinah, Saudi ArabiaFrom the Section of Colorectal Surgery, Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi ArabiaFrom the Director of General Health Affairs, Princess Nourah bint Abdulrahman University, Riyadh, Saudi ArabiaBACKGROUND: Stomas are associated with multiple complications including dehydration which ultimately affects renal function. These complications begin with changes in the estimated glomerular filtration rate (GFR). OBJECTIVES: Evaluate changes in GFR after stoma creation by stoma type and identify how different types of stoma affect GFR. DESIGN: Retrospective, analytical cohort SETTING: Tertiary care center in Saudi Arabia PATIENTS AND METHODS: The colorectal surgery database was reviewed for all adult patients who underwent stoma creation (permanent and temporary ileostomies and colostomies) or reversal in 2000–2015. GFR was estimated at the first encounter, before the index surgery, at the time of stoma reversal, and upon the last follow-up. Patients with renal impairment, including low GFR before stoma creation, patients who had a temporary stoma converted to a permanent stoma, and patients who died with a stoma were excluded. We studied the association of several demographic and clinical factors on changes in GFR by univariate and multivariate analysis. MAIN OUTCOME MEASURES: Estimated GFR at the last clinic visit for the permanent stoma group and at stoma closure for the temporary stoma group. SAMPLE SIZE: 394 patients (149 ileostomates, 245 colostomates) RESULTS: Thirty-three (8.4%) of the 394 patients had a low GFR: 11 (7.4%) in the ileostomy group and 22 (9%) in the colostomy group (P= .579). The rate of readmissions with ileostomies was higher (11.4%) than with colostomies (3.3%) (P≤.001). The number of temporary ileostomies (n=9, 7.0%) differed from temporary colostomies (n=2, 1.9%) but the difference was not statistically significant (P=.06). In the multivariate analysis, stoma permanency, hypertension, chemotherapy and nephrotoxic drugs were risk factors associated with low GFR. CONCLUSION: Ileostomies were not associated with a high rate of renal function deterioration in comparison to colostomies, but had a significantly higher rate of readmission due to dehydration and electrolytes imbalance possibly due to the hot climate in Saudi Arabia. LIMITATIONS: Retrospective nature and limited sample size which may have resulted in a type 2 statistical error. CONFLICTS OF INTEREST: None.http://www.annsaudimed.net/doi/10.5144/0256-4947.2023.76 |
| spellingShingle | Shimaa Saad Al Khaldi Reem Al Harbi Sara Albastaki Neamat Al Turki Luai Ashari Khuloud Alhassan Alaa Abduljabbar Denise Hibbert Asim Almughamsi Samar Al Homoud Nasser Alsanea Deterioration in renal function after stoma creation: a retrospective review from a Middle Eastern tertiary care center Annals of Saudi Medicine |
| title | Deterioration in renal function after stoma creation: a retrospective review from a Middle Eastern tertiary care center |
| title_full | Deterioration in renal function after stoma creation: a retrospective review from a Middle Eastern tertiary care center |
| title_fullStr | Deterioration in renal function after stoma creation: a retrospective review from a Middle Eastern tertiary care center |
| title_full_unstemmed | Deterioration in renal function after stoma creation: a retrospective review from a Middle Eastern tertiary care center |
| title_short | Deterioration in renal function after stoma creation: a retrospective review from a Middle Eastern tertiary care center |
| title_sort | deterioration in renal function after stoma creation a retrospective review from a middle eastern tertiary care center |
| url | http://www.annsaudimed.net/doi/10.5144/0256-4947.2023.76 |
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