Kidney Week

Abstract: SA-PO906

Iohexol Renal Measurement In Uro-Oncological Patients: Ready to Quit Pandora's Box?

Session Information

• CKD: Clinical, Outcomes, Trials - III
  November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Trevisani, Francesco, IRCCS San Raffaele Scientific Institute, Milan, Italy

Francesco Trevisani,

• Di marco, Federico, IRCCS San Raffaele Scientific Institute, Milan, Italy

Federico Di marco,

• Locatelli, Massimo, IRCCS San Raffaele Scientific Institute, Milan, Italy

Massimo Locatelli,

• Pizzagalli, Giorgio, IRCCS San Raffaele Scientific Institute, Milan, Italy

Giorgio Pizzagalli,

• Larcher, Alessandro, IRCCS San Raffaele Scientific Institute, Milan, Italy

Alessandro Larcher,

• Capitanio, Umberto, IRCCS San Raffaele Scientific Institute, Milan, Italy

Umberto Capitanio,

• Bettiga, Arianna, IRCCS San Raffaele Scientific Institute, Milan, Italy

Arianna Bettiga,

• Cinque, Alessandra, IRCCS San Raffaele Scientific Institute, Milan, Italy

Alessandra Cinque,

• Porrini, Esteban, University Hospital of the Canary Island, La Laguna, Spain

Esteban Porrini,

• Briganti, Alberto, IRCCS San Raffaele Scientific Institute, Milan, Italy

Alberto Briganti,

• Salonia, Andrea, IRCCS San Raffaele Scientific Institute, Milan, Italy

Andrea Salonia,

• Montorsi, Francesco, IRCCS San Raffaele Scientific Institute, Milan, Italy

Francesco Montorsi,

Background

An accurate assessment of renal function in urological and oncological patients should be mandatory to define the most appropriate urological surgery technique (nephron sparing vs radical nephrectomy) and to decide the correct dose for each type of chemo-immuno therapy. Unfortunately, the most used method to measure GFR in clinical practice is represented by the estimated glomerular filtration rate (eGFR) which harbours error in comparison to gold standards methods (mGFR). The objective of this study is to determine the extent of the error of eGFR in the oncological and urological pts category.

Methods

A prospectively consecutive cohort of 91 pts affected by uro-oncological neoplasm was collected comparing eGFR with mGFR using iohexol renal measurement. Four estimated GFR formulas were used for this study: CKD-EPI, MDRD, MCQ, FAS. The agreement them was evaluated taking in account Bias, expressed as median of percent difference between mGFR and eGFR and overall accuracy as P₃₀ representing the percent of estimates within 30% of measured GFR.

Results

The agreement between formulas and mGFR was poor. The Bias for MDRD was -1%, for CKD-EPI was 0%, for FAS was 1% and for MCQ was -19% indicating that, except for the latter, those formulas don’t harbour systematic errors. Different information was provided by the accuracy parameter: the P₃₀ was 81% for CKD-EPI, 76% for MDRD, 82% for FAS and 58% for MCQ.

Conclusion

In our cohort study we observed that formulas equally over or underestimate mGFR resulting in unbiased methods; however the magnitude of the over/underestimations is not negligible, at least ± 20 mL/min/1.73 m², and could led to errors in clinical management.

eGFR formulas vs mGFR: Black line represents identity; red dotted lines represent P₃₀ boudaries