ACS 2019: Variation in Estimated GFR Values Prior to Nephrectomy Based on Cystatin C, CKD-EPI, Cockcroft-Gault, and MDRD Formulas
Fifty-eight patients were enrolled: 67% male, mean age 62 ± 11 years, BMI 31± 8.2, and 22% were African American. eGFR values varied greatly: 34% of patients had values that ranged > 30 points. eGFR range was lowest for CKD-EPI (28-114) and highest for C-G (27-169). Patients with a eGFR < 60 ranged from 19% according to Cys-C to 33% according to C-G. PCC ranged from 0.47 (Cys-C + C-G) to 0.98 (CKD-EPI + MDRD). Variation positively correlated with eGFR mean (r = 0.53). They concluded eGFR values can widely vary for a single patient depending on the utilized equation, with significant implications for surgical planning, candidacy for neoadjuvant trials, and adjuvant treatments after nephrectomy. Current research is underway evaluating the impact of such variation on outcomes after extirpative renal surgery.
Presented by: Gordon Hong, BS, Emory University School of Medicine, Atlanta, Georgia, Emory University School of Medicine, Decatur, Georgia
Written by: Stephen B. Williams, MD, Medical Director for High Value Care; Chief of Urology, Associate Professor, Director of Urologic Oncology, Director Urologic Research, The University of Texas Medical Branch at Galveston, TX at the 2019 American College of Surgeons Clinical Congress October 27-31, 2019 - San Francisco, CA