Abstract: FR-PO216
Impact of Conventional Antitumoral Therapy on Estimated Glomerular Filtration Rate in Patients with Cancer Using Serum Creatinine and Cystatin C: A Prospective Cohort Study
Session Information
- Onconephrology: Immunotherapy Nephrotoxicity and Assessment of GFR
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1700 Onconephrology
Authors
- Caires, Renato A., Universidade de Sao Paulo, Sao Paulo, Brazil
- Inker, Lesley Ann, Tufts Medical Center, Boston, Massachusetts, United States
- Levey, Andrew S., Tufts Medical Center, Boston, Massachusetts, United States
- Burdmann, Emmanuel A., Universidade de Sao Paulo Laboratorios de Investigacao Medica, Sao Paulo, São Paulo, Brazil
- Costa e Silva, Veronica Torres, Universidade de Sao Paulo, Sao Paulo, Brazil
Background
The effects of chemotherapy on the estimated glomerular filtration rate (eGFR) are largely based on retrospective data, relying on serum creatinine (SCr). We aim to sequentially assess the impact of antitumoral conventional therapy on eGFR equations based on SCr and cystatin C (SCysC).
Methods
This is a prospective cohort of adult patients with solid tumors exposed to conventional antitumoral treatment at the São Paulo State Cancer Institute. eGFR was calculated through race-free CKD-EPI equations based on SCr (eGFRcr), on SCysC (eGFRcys), and the combined version (eGFRcrcys) in three moments: before the initiation of treatment (T0), during treatment (TM) and after the end of antitumoral therapy (TF). SCr and SCysC were measured through certified reference materials at the University of Minnesota.
Results
485 adult patients with solid tumors were recruited between Oct 2017 and Jan 2019. Patients were 53±15y, 62.3% female. The most frequently prescribed drugs were platinum compounds (cisplatin, carboplatin, oxaliplatin) (53.7%), paclitaxel (39.8%), and doxorubicin (27.4%). Patients received a median of 4(3-6) cycles during 105(63-148) days of chemotherapy. Median follow-up was 28(21-32) months. TM was collected 98 (84-119)days after T0, and TF was collected 124(44-204) days after the end of treatment. A significant decline in eGFR over time was observed in elderly patients, those with eGFRcrcys<60mL/min/1.73m2, reduced performance status, and exposed to cisplatin (Table).
Conclusion
Groups at higher risk of eGFR decline should be closely monitored and might be suitable candidates for prophylactic measures to minimize the impact of cancer treatment on GFR.
Funding
- Government Support – Non-U.S.