Kidney Week

Abstract: PUB446

Relevance of Measured GFR in the Onconephrological Panorama: An Essential Tool to Apply Precision Medicine

Session Information

• Publication Only

Category: Onconephrology

• 1700 Onconephrology

Authors

• Trevisani, Francesco, IRCCS Ospedale San Raffaele, Milano, Milano, Italy

Francesco Trevisani, MD, PhD

• Laurenti, Fabiana, Universita degli Studi di Verona Dipartimento di Neuroscienze Biomedicina e Movimento, Verona, Veneto, Italy

Fabiana Laurenti, MSc

• Simeoni, Mariadelina, Universita degli Studi della Campania Luigi Vanvitelli Dipartimento di Scienze Mediche Traslazionali, Napoli, Campania, Italy

Mariadelina Simeoni, MD, PhD, APN

• Cinque, Alessandra, IRCCS Ospedale San Raffaele, Milano, Milano, Italy

Alessandra Cinque

• Bettiga, Arianna, IRCCS Ospedale San Raffaele, Milano, Milano, Italy

Arianna Bettiga

• Capitanio, Umberto, IRCCS Ospedale San Raffaele, Milano, Milano, Italy

Umberto Capitanio, MD

• Salonia, Andrea, IRCCS Ospedale San Raffaele, Milano, Milano, Italy

Andrea Salonia

• Locatelli, Massimo, IRCCS Ospedale San Raffaele, Milano, Milano, Italy

Massimo Locatelli

• Pizzagalli, Giorgio, IRCCS Ospedale San Raffaele, Milano, Milano, Italy

Giorgio Pizzagalli, MD

• Montorsi, Francesco, IRCCS Ospedale San Raffaele, Milano, Milano, Italy

Francesco Montorsi

Background

An accurate assessment of renal function is fundamental in several categories of patients where the adequate medical or surgical treatment depends on the values of glomerular filtration rate (GFR). In particular, in the onco-nephrological scenario the determination of the “real” GFR can dramatically change the clinical algorithm and therefore the lifespan of patients. Unfortunately, the most used method to define the GFR is represented by eGFR which harbours a significant error in comparison to gold standards methods (mGFR). Aim of this study was to determine the extent of the error of eGFR compared to the mGFR in a consecutive cohort of patients affected by urological malignancies.

Methods

A consecutive cohort of 500 oncological patients affected by urological cancers enrolled in a single tertiary institution between 2018-2024 was collected in order to compare the most common eGFR formulas (Cockroft-Gault, MDRD, CKD-EPI 2012 and 2021, CKD-EPI cystatin, CKD-EPI creatinine and cystatin 2012 and 2021) with mGFR using Iohexol Plasma Clearance. True positives and False positives were classified in CKD stages based on eGFR and mGFR. Comparisons between groups were performed using Wilcoxon ranks sum test for numerical variables and Pearson’s Chi square test for categorical ones.

Results

Clinical data: overall median age was 66 years, median BMI 25, Male:536, F:165 , Diabetes: 10.9%, Hypertension: 53.8%, CKD stage I: 3.7%, II: 25.5%, IIIA: 28%, IIIB: 27.5%, IV: 13.4%, V: 1.74%, mean Creatinine: 1,44 mg/dl, cystatin: 1,24. We reported a huge discrepancy between the eGFR formulas and mGFR values, suggesting the essential role of mGFR in the clinical decision making algorithm (Figure 1 and 2).

Conclusion

In onco-nephrological scenario the use of eGFR remain debatable and misleading. mGFR is a crucial tool for a correct clinical decision based on precision medicine.