Abstract: SA-PO1233
GFR Decline During Anticancer Therapy Based on Multiple Filtration Markers: A Prospective Cohort Study
Session Information
- Onconephrology: Epidemiological Trends, Risk Stratification, and Clinical Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1600 Onconephrology
Authors
- Caires, Renato A., Universidade de Sao Paulo, São Paulo, SP, Brazil
- Inker, Lesley, Tufts Medical Center, Boston, Massachusetts, United States
- Allam, Krishna C., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
- Burdmann, Emmanuel A., Universidade de Sao Paulo, São Paulo, SP, Brazil
- Costa e Silva, Veronica Torres, Universidade de Sao Paulo, São Paulo, SP, Brazil
Background
Data assessing effects of anticancer therapy on estimated glomerular filtration rate (eGFR) are retrospective and rely on serum creatinine (Scr). We aimed to assess eGFR decline during anticancer therapy through equations based on Scr (eGFRcr), cystatin C (Scys) (eGFrcys), Scr and Scys (eGFRcrcys), and a panel of markers (Scr, Scys, beta-2-microglobulin, and beta-trace-protein) (eGFR4mark).
Methods
This is a prospective cohort of adult patients with solid tumors exposed to cytotoxic anticancer therapy at a tertiary cancer center in Brazil. eGFRcr, eGFRcys, eGFRcrcys, and eGFR4mark were calculated through race-free CKD-EPI equations before treatment (T0), in the middle of therapy (TM), and after therapy was concluded (TF).
Results
485 patients were recruited between October 2017 and January 2019. Patients were 53±15y, 62% female. Main cancer sites were breast (31%) and gastrointestinal (31%); 41% had metastasis. Most frequently prescribed drugs were platinum compounds (cisplatin, carboplatin, oxaliplatin) (53%) and paclitaxel (40%). Patients received a median of 4 (3-6) cycles during 105 (63-148) days of therapy. T0 was collected 4 (1-7) days before therapy, TM was collected 98 (84-119) days after therapy initiation, and TF 124 (44-204) days after therapy was concluded. In the mixed-effect models, exposure to cisplatin and any platin was associated with eGFR decline based on all assessed models, while etoposide was associated with GFR decline in all but eGFRcr. The magnitude of decline was higher for eGFRcrcys and eGFR4mark compared to eGFRcr (Figure).
Conclusion
This is the first study evaluating eGFR decline during cytotoxic therapy using multiple filtration markers. eGFRcr underestimated the decline compared to other equations.