Abstract: SA-PO211
Diversity of Nutritional Status in Patients with Cancer and CKD
Session Information
- Onco-Nephrology: Clinical
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onco-Nephrology
- 1500 Onco-Nephrology
Authors
- Souza, Micheline Tereza pires de, Sao Paulo State Cancer Institute - USP, Sao Paulo, Brazil
- Gil, Luiz Antonio, ICESP/ FMUSP, SAO PAULO, Brazil
- Caires, Renato Antunes, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
- Coura-Filho, George Barberio, ICESP, São Paulo, Brazil
- Costalonga, Elerson, School of Medicine, University of Sao Paulo, São Paulo, SÃO PAULO, Brazil
- Sapienza, Marcelo T., HCFMUSP, Sao Paulo, SÃO PAULO, Brazil
- Levey, Andrew S., Tufts Medical Center, Boston, Massachusetts, United States
- Inker, Lesley, Tufts Medical Center, Boston, Massachusetts, United States
- Burdmann, Emmanuel A., University of Sao Paulo Medical School, Sao Paulo, Brazil
- Torres, Veronica, Sao Paulo State Cancer Institute - USP, Sao Paulo, Brazil
Background
Cancer patients (pts) constitute a population with heterogeneous range of nutritional status. There is scanty prospective data on nutrition aspects of cancer pts with chronic kidney disease (CKD).
Methods
A group of solid cancer pts with CKD (not in dialysis) admitted for treatment (AT) or already in follow-up (FU) at a cancer hospital in Brazil (São Paulo State Cancer Institute) was prospectively evaluated between April 2015 and October 2017. Patients underwent an evaluation including bioimpedance exam, weight, height and subjective nutritional assessment questionnaire (PG-SGA), assessment of the glomerular filtration rate through 51 Cr-EDTA (rGFR), serum creatinine (SCr) and albumin (Alb). Chronic Kidney Disease (CKD) was defined as rGFR <60 ml / min / 1.73 m2. Sarcopenia was defined when as Fat Free Mass Index ≤17.4kg/m2 for men and ≤15kg/m2 for women.
Results
One hundred sixty-one pts were enrolled. Pts characteristics were age 69.92 ± 10.46 years, 61.5% male, 72% AT. Most common tumor origins were: genitourinary tract 41%; gastrointestinal tract 12.4%, breast cancer 13.7%. ECOG was 0-1 in 89.5%, clinical stage III and IV comprised 53.4% of pts, with evidence of metastatic disease (MD) in 22.4%. Median rGFR was 49.9 (39.67 – 55.81) ml/min/1.73m2, SCr was 1.18 (0.96 – 1.44) mg/dL and Alb was 4.30 (4.10 – 4.60) g/dL. Nutrition evaluation revealed: weight 71 (62.6-80.35) Kg; body mass index (BMI) 25.71 (22.3 – 29.1); fase angle 5.20 (4.60 – 5.90); fat free mass 46.4 (39.4-56.25) Kg. BMI was < 23 in 29.8% and > 28 in 34.2% of pts. Sarcopenia was observed in 28.6% of pcts and 81.4% of pcts were considered well nourished by PG-SGA. AT and FU pcts presented no difference in either baseline variables (age, ECOG, MD, comorbidities, clinical stage, SCr, Alb) and in most of nutrition aspects (weight, sarcopenia, fase angle, fat free mass) (data not shown). FU pcts presented higher BMI (27.1 [24.2 – 30.20] vs 25.10 [22.2 – 28.7], P=0.330 and higher prevalence of well-nourished status by PG-SGA (93.3 vs 76.7%, P=0.015).
Conclusion
The nutritional status in cancer pts with CKD is diverse, ranging from significant malnutrition to expressive overweight both for AT and FU pts.