|
|
67th Annual Meeting Abstracts
Baseline GFR and CKD Stages in Patients Presenting to a Tertiary Care Center for Evaluation of a Solid Renal Mass
*Jason Rothman1, *Alexander Kutikov2, *Kevan Iffrig2, *Deb Kister2, *Michelle Collins2, Robert G Uzzo2
1Temple University Hospital, Philadelphia, PA;2Fox Chase Cancer Center, Philadelphia, PA
Introduction: Serum creatinine (Scr) does not adequately reflect renal function in patients with solid renal masses. Estimated glomerular filtration rate (eGFR) serves as the basis of CKD staging. We evaluated the prevalence of baseline CKD in a cohort of patients with renal masses referred to a tertiary care center.
Materials & Methods: Using our institutional database, we identified patients undergoing kidney surgery from 1/2000-6/2008. Scr was used to calculate the eGFR with the MDRD formula.
Results: 826 had adequate data to calculate preoperative eGFR. 51%(423/826) had a Scr of 1.0mg/dl or less. Overall, 20% (165/826) had CKD Stage I or less. 54%(445/826) had CKD II. 24% (197/826) had CKD III. 1%(9/826) had CKD IV and 1%(10/826) had CKD V (Table). Importantly, in patients 70 years and older, 47% (112/245) had CKD Stage III or greater at baseline with a median eGFR of 62 ml/min (mean 61ml/min, range 7-102ml/min).
Conclusions: Although 83% of patients presenting for surgery with a renal mass had a "normal" baseline Scr(<1.4mg/dl), over 25% of all patients had CKD Stage III or greater. Nearly 50% of patients 70 years and older had CKD Stage III or greater. Nationally nephron sparing surgery is underutilized, particularly in the elderly. Given the high incidence of CKD in patients with renal masses, a concerted effort must be made to preserve renal function when surgically treating RCC.
Patient Information| No. Patients | 826 | Age
18-35
36-45
46-55
56-65
66-75
76-85
>85 | No. (%)
17 (2)
79 (10)
150 (18)
253 (31)
211 (26)
110 (13)
6 (1) | Serum Creatinine
<1.0
1.1-1.4
1.5-1.8
1.9-2.2
2.3-2.6
>2.7 | No. (%)
423 (51)
262 (32)
108 (13)
17 (2)
5 (1)
11 (1) | CKD
Stage 1 or no disease
Stage 2
Stage 3
Stage 4
Stage 5 | No. (%)
165 (20)
445 (54)
197 (24)
9 (1)
10 (1) | Type of Procedure
Nephrectomy
Partial Nephrectomy
Ablative Therapy | No. (%)
476 (58)
297 (36)
53 (6) |
|
|
