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Abstract: PO1863

Impact of CKD on the Nutritional Status of Patients with Cancer

Session Information

Category: Onco-Nephrology

  • 1500 Onco-Nephrology

Authors

  • Souza, Micheline Tereza pires de, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil
  • Gil, Luiz Antonio, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil
  • Cardenas, Thais de Campos, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil
  • Caires, Renato Antunes, Sao Paulo State Cancer Institute, Sao Paulo, Sao Paulo, Brazil
  • Costalonga, Elerson, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil
  • Coura-Filho, George Barberio, Sao Paulo State Cancer Institute, Sao Paulo, Sao Paulo, Brazil
  • Sapienza, Marcelo T., University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil
  • Inker, Lesley Ann, Tufts Medical Center Cancer Center, Boston, Massachusetts, United States
  • Levey, Andrew S., Tufts Medical Center Cancer Center, Boston, Massachusetts, United States
  • Burdmann, Emmanuel A., University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil
  • Costa e Silva, Veronica Torres, Sao Paulo State Cancer Institute, Sao Paulo, Sao Paulo, Brazil
Background

Cancer patients routinely live with impaired nutritional status and other comorbidities. There are few prospective data on the impact of chronic kidney disease (CKD) on the nutritional aspects of patients with cancer.

Methods

Patients with solid cancer, admitted for treatment at a cancer hospital in Brazil (Instituto do Câncer do Estado de São Paulo) were prospectively evaluated between April2015 and October2017. Patients underwent a nutritional evaluation including subjective global assessment produced by the patient(PG-SGA), anthropometry(Arm Muscle Area-AMB, weight, height) and electrical bioimpedance(BIA). Sarcopenia was defined as a fat-free mass index(BIA) ≤17.4kg /m2 for men and≤15kg/m2 for women. Measurement of the glomerular filtration rate was determined through plasma clearance of 51Cr-EDTA (mGFR).CKD was classified according to the KDIGOguidelines based on mGFR indexed for body surface area.

Results

Six hundred and ninety-six pts were enrolled.Patients were 60(51-67) years,51.9%male.The most common cancer sites were breast(26.3%), prostate(20%), and gastrointestinal(12.2%).A total of 14.7%had metastatic disease,94.9% ECOG 0or1.Median mGFR was 81.1(66.7-94.6), with 55.7%,32.8% and 11.5% presenting mGFR G1,G2andG3, respectively. When compared to patients with mGFR G1,patients with mGFR G2andG3 had a higher frequency of malnutrition by PG-SGA and BMI,and a higher proportion of muscle deficit according to AMB.In addition,fat free mass deficit,sarcopenia and lower phase angle values were more frequently observed in mGFR G2 and G3 according to the BIA data(Table1).

Conclusion

In patients with cancer admitted for treatment lower mGFR was associated with worse nutritional status.Therefore,nutritional monitoring in conjunction with the oncology,nephrology and nutritional team is necessary.