A5926 hypertension and renal function in patients with breast cancer

Abstract

Objectives: Over time, particularly in the last 10 to 15 years, nephrology consult and/or critical care nephrology services, oncology patients make up a significant number of the patients we see for kidney related-problems while hypertension is the most commonly reported comorbidity in cancer patients. Breast cancer is the leading cause of morbidity and mortality in women of all ages. In general, women with early-stage breast cancer undergo primary surgery to the breast and regional nodes with or without radiation therapy (RT). The aim of the pilot study was to assess kidney function and prevalence of hypertension in patients with breast undergoing surgery. Methods: The pilot study included 100 consecutive patients with breast cancer undergoing primary surgery with curative intent. Using the MDRD and CKD-EPI formula, the glomerular filtration rate (eGRF) and creatinine clearance using the Cockcroft-Gault formula were estimated and a group of patients with chronic kidney disease were identified. Blood pressure was measured with standard protocols. Hypertension was defined as either a blood pressure of at least 140/90 mm Hg or hypotensive medication use. Results: Patients with breast cancer were 53 ± 14 years of age, with serum creatinine of 0.68 ± 0.14 mg/dl eGFR by CKD-EPI of 99 ± 18 ml/min/1.72m2. Prevalence of chronic kidney disease (eGFR below 60 ml/min by CKD-EPI) was 5% in breast cancer Hypertension was present in 37%, but in the elderly (over 65 years) prevalence was 74%. Conclusion: Hypertensive females with breast cancer had worse kidney function as reflected by higher serum creatinine and lower estimated glomerular filtration rate, higher BMI and fibrinogen, which reflects general inflammatory state. After dividing patients according to age ( ≤ vs > 65 years) and presence of hypertension, elderly hypertensive females