Abstract: SA-PO1231
Variability in Proteinuria Screening During Vascular Endothelial Growth Factor/Tyrosine Kinase Inhibitor Therapy: Room for Improvement!
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
- O'Brien, Kathryn, UPMC, Pittsburgh, Pennsylvania, United States
- Pantanowitz, Joshua, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
- Ramadugu, Anvith, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
- Amarapurkar, Pooja D., UPMC, Pittsburgh, Pennsylvania, United States
Background
Despite known nephrotoxicity risks, proteinuria surveillance in patients receiving vascular endothelial growth factor inhibitors (VEGFI) and tyrosine kinase inhibitors (TKI) agents lacks standardization. We evaluated practice patterns and gaps to target areas for improvement in patients receiving VEGFI/TKI therapies.
Methods
We conducted a single center quality improvement analysis of adult cancer patients receiving VEGF/TKI therapy. Process measures included presence of baseline proteinuria, methods of baseline and longitudinal proteinuria screening, and the highest tier test used (urinalysis, urine protein creatinine ratio [UPCR], urine albumin creatinine ratio [UACR], or 24 hour urine collection). Screening practices were compared by cancer type (renal cell carcinoma [RCC] vs non RCC).
Results
Of 29 patients (15 Renal cell cancer (RCC) and 14 non RCC) baseline proteinuria was present in 28% (8/29) of patients and was more frequent with RCC (5/8, 63%) compared to (3/8, 37.5%) non RCC cancers. Only 58% (11/29) of all patients had baseline proteinuria screening. Of these, 6 had baseline proteinuria. Urinalysis was the predominant screening method in 65% (11/17) at baseline and during follow up. Quantitative proteinuria assessment was limited and inconsistent. (Figure 1) There was substantial heterogeneity in the choice of tested used and frequency of follow up testing. This pattern was observed across cancer types. Even in high risk patients, escalation to quantitative testing was not reliably sustained.
Conclusion
Our study demonstrates that baseline and longitudinal proteinuria screening during VEGF/TKI therapy is highly variable, with only 58% of patients receiving baseline screening. Longitudinal monitoring often involves urinalysis alone and lacks protein quantification. Despite the single center and small sample size, our findings highlight the variability in practice and need for standardize guidelines for proteinuria screening and monitoring in patients on VEGF/TKI.