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Kidney function after urinary diversion | CION Cancer Clinics
Kidney function can fall slowly, over years, in some people after an ileal conduit, a neobladder or a pouch. Most people keep enough for a normal life. The causes, a narrowing at the join, infections, stones and back pressure, show on a blood test and an ultrasound long before you feel anything. This page explains the words on your report, how the kidneys are watched, and what protects them. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- Does kidney function fall after an ileal conduit?
- The kidney words on your blood test and scan, in plain language
- How are my kidneys watched after the operation?
- What quietly wears kidney function down, and what is done about it?
- Four things families tell us about the kidneys
- What can I do to protect my kidneys?
- Common questions about kidney function after diversion
The short answer
Does kidney function fall after an ileal conduit?
It can, slowly, over years, in some people. Most people keep enough kidney function for a normal life. The fall, when it happens, has causes that can be found on a blood test and a scan long before you feel anything, which is why follow-up after this operation never stops.
Why the kidneys are involved at all
The kidneys were never touched in the operation. What changed is the plumbing below them. The ureters, the tubes from each kidney, are now stitched into a piece of bowel instead of the bladder. Anything that slows the flow through that join, pushes urine back up it, or lets infection travel along it, puts pressure on the kidney above. Pressure over years is what wears kidney function down.
What else is going on
Many people having this operation are older, and some already have diabetes, high blood pressure or kidney function that was lower than normal before surgery. The chemotherapy often given before a cystectomy is also hard on the kidneys. So a fall after a conduit is rarely the conduit alone, which is why every part of it is watched.
The same applies to a neobladder and a pouch
The join between the ureters and the bowel exists in every type of diversion. A neobladder or pouch adds one more risk: urine left behind after emptying.
If you had only one working kidney before surgery, tell every doctor you see. The follow-up is closer.On your report
The kidney words on your blood test and scan, in plain language
- Creatinine
- A waste product the kidneys clear from the blood. A rising creatinine means the kidneys are clearing less.
- eGFR
- An estimate of how much blood the kidneys filter each minute, worked out from creatinine, age and sex. A falling eGFR is the number your team watches most closely.
- Hydronephrosis
- A kidney swollen because urine is held up below it. Seen on ultrasound. It is a sign that flow is blocked somewhere, not a diagnosis on its own.
- Stricture
- A narrowing, usually from scar tissue, at the join between a ureter and the bowel. The commonest fixable cause of a swollen kidney after this operation.
- Reflux
- Urine flowing backwards from the conduit or pouch up towards the kidney, most often when the bag or pouch is full.
- Metabolic acidosis
- The blood becoming slightly more acidic because the bowel segment absorbs some of what is in the urine. Treatable with tablets, and worth correcting because it strains the kidneys and the bones.
Not sure whether this applies to you?
Ask an oncologistThe checks
How are my kidneys watched after the operation?
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Before surgery
Blood tests and a scan record where your kidneys started. Every later result is compared with this baseline, so keep a copy.
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In hospital and after the stents come out
Small tubes called stents are often left across the new joins to hold them open while they heal. When they are removed, a scan confirms urine is draining freely from both kidneys.
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The first year
Blood tests for kidney function and acid balance, and an ultrasound, at each follow-up visit. This is when a narrowing at the join most often shows itself, usually as a swollen kidney on the scan before any symptom.
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Every year after that
The same blood tests and scan continue for life, alongside the cancer follow-up. A narrowing can appear years later, and so can stones, so the checks do not stop when the cancer checks ease off.
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If something changes
A rising creatinine, a swollen kidney, or repeated infections trigger a closer look: a CT, sometimes a scan of how well each kidney drains, and a decision about whether the join needs to be opened up.
The causes
What quietly wears kidney function down, and what is done about it?
Four things. Each is looked for at follow-up and each has a treatment.
A narrowing at the join
Scar tissue where the ureter meets the bowel slowly closes the opening. Urine backs up and the kidney swells. It can be stretched open from inside, or the join can be redone in a small operation.
Repeated kidney infections
Each true kidney infection can leave a small scar. Several over the years add up. Finding why infections keep happening, rather than treating each one alone, is what protects the kidney.
Stones
Mucus, still urine and the change in acid balance all make stones more likely, in the kidney and in the conduit or pouch. Stones block flow and shelter bacteria. Water and treating the acid balance are the main prevention.
Back pressure from a full bag or pouch
A bag left to fill, or a neobladder emptied too rarely, pushes urine back up towards the kidneys. Emptying at a third full, a night drainage bag, and emptying a neobladder by the clock keep the pressure low.
High blood pressure and diabetes add to all four. Keeping them controlled is kidney care too.Leave a number, we will call you
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Commonly believed
Four things families tell us about the kidneys
"The kidneys were not operated on, so they are not affected."
The kidneys were left alone, but their outflow was rebuilt. A narrowing or back pressure at the new join affects the kidney above it just as a blocked pipe affects the tank. That is why kidney tests are part of every follow-up.
"He feels fine, so his kidneys must be fine."
Kidney function can fall a long way before anyone feels it. A swollen kidney on ultrasound usually causes no pain at all. The blood test and the scan are the only early warning, so feeling well is not a reason to skip follow-up.
"Drinking less will rest the kidneys."
The opposite. Less fluid means concentrated urine, more stones, more infection and more strain. Plain water spread through the day is the single most useful thing you can do, unless your team has given you a fluid limit for a heart condition.
"A falling eGFR means dialysis is coming."
A fall on one test is a reason to look for a cause, not a verdict. A narrowing can be opened, an infection treated, the acid balance corrected, and the number often steadies or recovers. Dialysis after a diversion is uncommon and is never the next step after one result.
Day to day
What can I do to protect my kidneys?
Drink enough, keep urine moving, keep the follow-up appointments, and be careful with painkillers. That covers most of what is in your hands.
Painkillers and other medicines
Common painkillers of the ibuprofen and diclofenac type, sold over the counter for joint and back pain, are hard on kidneys that are already under strain. Ask before taking them regularly. Tell every doctor and chemist you see that you have a urinary diversion, because some medicines and scan dyes need a kidney check first.
Blood pressure and sugar
If you have high blood pressure or diabetes, keeping them controlled protects the kidneys as much as anything the surgical team does. Bring those readings to the same follow-up visits.
What this page cannot tell you
It cannot tell you what your own kidney function is, or whether a fall on your report matters. That depends on your baseline, the trend across visits, your other conditions and what the scan shows. It also cannot tell you whether a narrowing needs treatment now or watching. Ask your team those two questions directly and write down the answers.
Bring every blood report, including ones from other hospitals, to each visit. The trend is what your team reads.Questions we are asked
Common questions about kidney function after diversion
My creatinine has gone up slightly. Should I worry?
One slightly higher reading is common and can follow a hot day, a poor fluid intake or an infection. What matters is the trend across several visits, and what the ultrasound shows. Ask your team to compare it with your baseline before surgery rather than reading the single number on its own.
Why do I need a scan when the blood test is normal?
Because one kidney can swell and lose function while the other keeps the blood test normal. The ultrasound looks at each kidney separately and can show a blockage long before the blood test moves. That is why both are done, not one or the other.
What happens if a narrowing is found at the join?
It depends on how much the kidney is affected. A mild narrowing may simply be watched. A tighter one can be stretched or held open with a tube from inside, or the join can be redone in an operation. Your surgeon will explain which is being suggested for you and why.
Can I take my usual painkiller for knee pain?
Ask first. The ibuprofen and diclofenac type of painkiller, including gels and combination tablets, can strain the kidneys, especially with a low fluid intake. Your team may suggest a different painkiller. Never change or stop a medicine on your own; ask the doctor who prescribed it.
Does the acid balance problem affect my kidneys too?
Yes. The bowel segment absorbs some of what is in the urine and can make the blood slightly acidic. Left alone, that strains the kidneys and weakens the bones. It is picked up on a routine blood test and usually corrected with a simple tablet, which is one more reason to keep the follow-up.
Will I need dialysis one day?
Most people do not. The causes of a falling kidney function after diversion are mostly ones that can be found and fixed if the follow-up is kept. The people at higher risk are those who already had reduced kidney function, diabetes or one kidney before surgery, and their team watches them more closely.
How much water should I drink?
Enough that the urine stays pale, spread through the day, and more on hot days and when working outside. There is no single figure that fits everyone, and some people with heart conditions have a limit. Ask your team for a target that suits you and stick to it.
Are the follow-up scans and tests covered by my scheme?
Follow-up after cancer surgery, including the blood tests and ultrasound, is usually part of the cancer care pathway. Aarogyasri, CGHS, ECHS and EHS are accepted and most cashless insurers are empanelled. Call the helpline with your card details and we will check your cover before you travel.
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Sources
- National Cancer Institute — Bladder Cancer Treatment (PDQ) - Patient Version
- NICE — Bladder cancer: diagnosis and management (NG2)
- NHS — Chronic kidney disease
- American Cancer Society — Urostomy guide
- NHS — Urostomy
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Urine Infections After Urinary DiversionRepeated infections are one of the causesMetabolic Problems After Bowel-Based DiversionThe acid balance problem that strains the kidneysFollow-Up After Radical CystectomyThe visits where kidney tests are doneIleal Conduit ExplainedHow the ureters are joined to the bowelThe Pathology Report After SurgeryReading the other report you were handed
Talk to us
A kidney result you do not understand?
Send it to us or call the helpline. A surgical oncologist who deals with urinary diversion every week will read it with you and tell you what the next step actually is. One helpline serves every CION centre.