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Abstract: SA-PO147

Association of Kidney Volume Measurement to 2021 CKD-EPI Estimating Equations Improves the Prediction of Measured Glomerular Filtration Rate in Cancer Patients

Session Information

Category: Onconephrology

  • 1600 Onconephrology

Authors

  • Strufaldi, Fernando Louzada, Universidade de Sao Paulo Hospital das Clinicas, Sao Paulo, São Paulo, Brazil
  • Bezerra, Regis Franca, Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Costa e Silva, Veronica Torres, Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, São Paulo, Brazil
Background

It has been demonstrated that adding total kidney volume (TKV) measurement to glomerular filtration rate (GFR) estimating equations in multivariate linear regression models can improve the prediction of measured GFR in cancer patients. However, the 2021 CKD-EPI equations, now recommended in the United States, have not been assessed in this context

Methods

We enrolled 189 patients with solid tumors at an academic cancer Hospital in Brazil (Instituto do Câncer do Estado de São Paulo) who had undergone abdominal imaging and GFR measurement by plasma clearance 51Cr-EDTA within 60 days. eGFR was determined based on the 2021 CKD-EPI equations using Scr (eGFRcr) and Scr combined with Scys (eGFRcr-cys). eGFR and mGFR were non-indexed for body surface area. TKV was measured using a semi-automatic segmentation program, excluding non-functional tissues. The correlations between mGFR and TKV, as well as, mGFR and eGFR, were calculated using the Pearson Correlation Coefficient (PCC). Linear regression models were built, having TKV and eGFR equations as predictors and mGFR as the outcome

Results

Patients were 56.3(14.0) years old, 49.2% male. Most common cancer sites were breast (18.0%), colorectal (12.7%), and stomach (10.1%). 96% of patients were ECOG 0/1. Mean (SD) Body mass index was 27.18 (5.6). Mean (SD) mGFR, eGFRcr and eGFRcr-cys were 81.2(22.2), 91.5(20.9), and 87.6(23.2), ml/min, respectively. Mean(SD) TKV for both kidneys was 311.6 (76.2) cm3.PCC for mGFR-TKV, mGFR-eGFRcr and mGFR-eGFRcr-cys were 0.79, 0.81, and 0.87, respectively. TKV improved the coefficient of determination of the linear regression models when added to both eGFRcr and eGFRcr-cys, in overall and assessed subgroups (Table 1)

Conclusion

In conclusion, our results suggest that TKV measurement improves the prediction of mGFR in association with the 2021 CKD-EPI equations in cancer patients. Thus, TKV could potentially be incorporated to enhance GFR estimation in clinical practice