EAU 2019: Development and Validation of a Novel Scoring Index CART to Predict Renal Functional Decline Post Partial Nephrectomy
A multi-institutional dataset was utilized for analysis and validation of patients undergoing partial nephrectomy. Multivariable analysis was carried out for potential variables associated with development of de-novo post-operative chronic kidney disease (CKD) stage IIIB at last follow-up.
Authors analyzed a total of 924 patients. Factors on Multivariable analysis associated with increased risk of development of eGFR<45 included age >65, African-American race, C-reactive protein level >0.5mg/dL, and tumor size >4 cm. For CART (C-reactive protein, Age, Race, Tumor size) score, the following values were assigned: age (≤65=1, age >65=3), race (non-African-American=1, African-American=2), tumor size (≤4=1, >4cm=2), and CRP (≤0.5mg/dL=1, >0.5mg/dL=4). Analysis demonstrated 2.6% of patients with a low score had de novo eGFR<45 postoperatively, while 35% of patients with a high score had de novo eGFR<45.
Dr. Derweesh concluded that CART score represents a novel composite score that significantly predicts the development of eGFR<45 after surgery. This scoring system may provide adjunctive information to inform patient counseling and clinical decision making, as well as an impetus to improve outcomes in at-risk patient subgroups.
Presented by: Ithaar H. Derweesh, MD, Urologic Oncologist, Professor of Urology and Radiology, UC San Diego Health, San Diego California
Written by: Ekaterina Laukhtina, medical student, Institute for Urology and Reproductive Health, Sechenov University at the 34th European Association of Urology (EAU 2019) #EAU19 conference in Barcelona, Spain from March 15-19, 2019.