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Kidney Week

Abstract: FR-PO220

Temporal and Apparent Decrease of Creatinine-Derived eGFR in the Patients with Cancer Treated with Poly ADP-Ribose Polymerase Inhibitors

Session Information

Category: Onconephrology

  • 1700 Onconephrology

Authors

  • Morimoto, Shiho, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
  • Onishi, Yasuhiro, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
  • Ariki, Saori, Department of Pharmacy, Okayama University Hospital, Okayama, Okayama, Japan
  • Morinaga, Hiroshi, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
  • Tanabe, Katsuyuki, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
  • Uchida, Haruhito A., Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
  • Zamami, Yoshito, Department of Pharmacy, Okayama University Hospital, Okayama, Okayama, Japan
  • Masuyama, Hisashi, Department of Obsterics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
  • Araki, Motoo, Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
  • Wada, Jun, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
Background

Poly ADP-ribose polymerase (PARP) inhibitors, novel molecular targeted drugs used mainly for Breast cancer gene (BRCA) mutation-positive tumors, have been reported to cause an increase in serum creatinine (Cr). It has been reported that PARP inhibitors, which are molecularly targeted drugs, have an off-target effect on tubular transporters (MCT2, MATE1) and suppress Cr secretion into the urine, leading to an increase in serum Cr independent of glomerular filtration rate. With this study, we aimed to assess the relationship between renal function and PARP inhibitors.

Methods

We retrospectively recruited the patients attending Okayama University Hospital who received PARP inhibitors for the first time from April 2018 to December 2022. We compared the levels of BUN, serum Cr, and Cr-derived eGFR at baseline, on treatment, and off treatment using one-way repeated measures ANOVA and post-hoc analyses.

Results

Of 85 patients, with an average age of 60.7±12.5 years and 96.5% female, the mean eGFR was calculated as 72.9±13.1 ml/min/1.73m2. eGFR significantly decreased to 62.6±12.3 one month after starting PARP inhibitor (P<0.001), but improved to 71.6±16.6 one month after discontinuation (P<0.001) and there was no significant increase in BUN (Figure 1A, B). Until 96 weeks, creatinine-derived-eGFR remained unchanged from one month after initiation of PARP inhibitor (Figure1C). Multiple regression analysis showed a negative correlation between post-treatment eGFR decline and starting eGFR (P<0.001).

Conclusion

The present study showed that the increase in serum Cr after the PARP inhibitor was temporary and did not increase BUN, suggesting the apparent change in eGFR.

Funding

  • Government Support – Non-U.S.