Kidney Week

Abstract: FR-PO219

Impact of CKD Stages Based on Measured vs. Estimated Glomerular Filtration Rate on the Overall Survival of Patients with Cancer

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

• Ribeiro, Rayra Gomes, Universidade de Sao Paulo, Sao Paulo, Brazil

Rayra Gomes Ribeiro, MD

• Kitchlu, Abhijat, University of Toronto, Toronto, Ontario, Canada

Abhijat Kitchlu, MD, MS, MSc

• Inker, Lesley Ann, Tufts University, Medford, Massachusetts, United States

Lesley Ann Inker, MD, MS

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

Veronica Torres Costa e Silva, MD

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

Renato A. Caires, MD

• Costalonga, Elerson, Universidade de Sao Paulo, Sao Paulo, Brazil

Elerson Costalonga, MD, PhD

• Sapienza, Marcelo Tatit, Universidade de Sao Paulo, Sao Paulo, Brazil

Marcelo Tatit Sapienza, MD, PhD

• Burdmann, Emmanuel A., Universidade de Sao Paulo, Sao Paulo, Brazil

Emmanuel A. Burdmann, MD, PhD

Background

Data assessing the impact of chronic kidney disease (CKD) stages on the overall survival (OS) of cancer patients are largely retrospective and rely on the serum level of creatinine (SCr) to estimate the glomerular filtration rate (eGFR). We aimed to evaluate the impact of different CKD stages on the OS of patients with cancer admitted for treatment using measured GFR (mGFR) and eGFR.

Methods

This is a prospective cohort of adult patients with solid tumors (diagnosed in the last 90 days) initiating treatment at the Sao Paulo State Cancer Institute. mGFR was determined by plasma clearance of ⁵¹Cr-EDTA. eGFR was calculated using the 2021 CKD-EPI equations, based on SCr (eGFrcr), Scys (eGFRcys), and the combined version (eGFRcrcys). CKD stages were classified according to the KDIGO guidelines using mGFR, eGFRcr, eGFRcys, and eGFRcrcys.

Results

A group of 1,011 patients recruited from April 2015 to September 2017 were included for analysis and censored in March 2023. Patients were 50.6 ±13 y, 50.7% female. The most common cancer sites were breast (22.4%), gastrointestinal (21.9%), and male genital (21.2%); 15.5% had metastasis. ECOG 0, 1, and 2&3 comprised 64%, 32%, and 6% of patients, respectively. Time of follow-up was 5.7 (2.5-6.5) y; overall mortality was 27.4%. In the adjusted Cox regression model, stage 3b CKD based on mGFR and eGFRcys and stages 3a and 3b based on eGFRcys were associated with worse OS. CKD stages based on eGFRcr were not associated with OS (Table).

Conclusion

This is the first study assessing the impact of CKD stages on the OS of patients with solid tumors incorporating mGFR and SCys. Our results endorse the utility of eGFRcys and mGFR as valuable instruments in the kidney care of cancer patients.