Kidney Week

Abstract: PUB441

Prevalence of CKD Based on Estimated Glomerular Filtration Rate Using Creatinine and Cystatin C in Patients with Cancer Exposed to Conventional Chemotherapy: A Prospective Study

Session Information

• Publication Only

Category: Onconephrology

• 1700 Onconephrology

Authors

• Caires, Renato A., Universidade de Sao Paulo, Sao Paulo, Brazil

Renato A. Caires, MD

• Inker, Lesley Ann, Tufts Medical Center, Boston, Massachusetts, United States

Lesley Ann Inker, MD, MS

• Burdmann, Emmanuel A., Universidade de Sao Paulo Laboratorios de Investigacao Medica, Sao Paulo, São Paulo, Brazil

Emmanuel A. Burdmann, MD, PhD

• Costa e Silva, Veronica Torres, Universidade de Sao Paulo, Sao Paulo, Brazil

Veronica Torres Costa e Silva, MD

Background

Data on the impact of conventional chemotherapy (chemo) on development of chronic kidney disease (CKD) are largely based on retrospective surveys and rely on serum creatinine (SCr) to estimate the glomerular filtration rate (eGFR). We assessed the prevalence of CKD during chemo using eGFR equations based on SCr and cystatin C (SCysC)

Methods

This is a prospective cohort of patients with solid tumors exposed to chemo at São Paulo State Cancer Institute. eGFR was calculated through race-free CKD-EPI equations based on SCr (eGFRcr); SCysC (eGFRcys); or the combined version (eGFRcrcys) in three moments: before initiation of chemo (T0), during treatment (TM) and after end of chemo (TF). SCr and SCysC were measured through certified reference materials at the University of Minnesota. CKD was defined as eGFR<60mL/min/1.73m²

Results

485 adults with solid tumors were recruited between Oct2017 and Jan2019. Patients were 53±15y, 62.3% female. Most 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 chemo. 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 end of chemo. At this point, increased prevalence of CKD was observed in elderly, worse performance status, metastasis, or treated with cisplatin (Table)

Conclusion

In this cohort of adults with solid tumors, CKD developed more frequently in patients at higher risk. eGFRcr appeared to underestimate CKD prevalence compared to eGFRcys and eGFRcrcys in overall population and in most important subgroups

Funding

• Government Support – Non-U.S.