How to Protect Your Kidney Health if You Have Metastatic Bladder Cancer

One of the more common complications is a ureteral obstruction, which is a blockage of the tubes that drain from the kidneys into the bladder. “The tumor can block the ability of urine to flow from the ureter [tubes] into the bladder,” says Elizabeth Plimack, MD, a medical oncologist at Fox Chase Cancer Center in Philadelphia. This can cause kidney swelling, injury, or failure.

Keeping your kidneys healthy may also help you manage the bladder cancer. Healthy kidneys help remove waste and extra fluid, strengthen bone health, and support blood pressure and red blood cell production — all of which help you stay well enough for current and future bladder cancer treatments. Here’s what you should know about how to protect your kidney health.

• Blood in the urine
• Changes in urination, such as going more often, having trouble starting or, especially, feeling as if you can’t fully empty your bladder
• Pain in your kidneys, which may feel like back pain
• Recurring urinary tract infections
• High blood pressure (hypertension)
• Low-grade fever
• Nausea
• Pain between your upper belly and back (flank pain)
• Swelling in one or both legs

While some of these symptoms, such as blood in the urine, can also be caused by the cancer itself, others — such as feeling like you can’t pass urine, despite having a full bladder — warrant a trip to the emergency room, says Dr. Plimack.

When a blockage is caught early, doctors can often relieve it by inserting a ureteral stent (a thin tube that keeps urine flowing) or placing nephrostomy tubes.

Preventing dehydration by keeping tabs on your fluid intake can help your kidneys function. Plimack recommends measuring your water intake, aiming for about two liters a day. (Talk to your doctor for specific recommendations.)

“Keep a water bottle, fill it, deplete it, and fill it again,” she says. “Measure your fluid intake in a diary,” such as in a notebook or notes app.

Next, pay attention to how often you urinate and look for changes in urine volume or color. If there are noticeable changes, report them to your care team. Remember that your doctor is also keeping tabs on your kidney function. You may have blood or imaging tests before chemotherapy cycles, at routine oncology visits, and anytime symptoms change, says Plimack.

Some of the people on your care team who can help protect your bladder and kidney health include:

• An oncologist, who manages the cancer treatment and adjusts drug dosing based on kidney function
• A urologist, who treats blockages and places stents or nephrostomy tubes when needed
• An onco-nephrologist, who provides specialized kidney care for people with cancer
• A caregiver, who can help notice changes in urine, swelling, or other symptoms, keep track of appointments and medications, and support daily monitoring. “Every time someone has a visit where we’re discussing a change or a new treatment, it’s so helpful to have a caregiver there,” says Plimack.

By working together and communicating openly, you and your care team can catch any issues early on and keep your kidneys functioning well.

• Healthy kidneys support waste removal, blood pressure, bone health, and red blood cells.
• Possible symptoms of kidney problems include back or side pain, blood in urine, changes in urination, nausea, and swelling.
• Drink plenty of water every day, pay attention to your urine, stick to your medical appointments, and ask for help from caregivers when needed.