MP24-01 RACE BASED EQUATIONS FOR ESTIMATING KIDNEY FUNCTION MAY CONTRIBUTE TO RACIAL DISPARITIES IN PARTIAL NEPHRECTOMY UTILIZATION AMONG BLACK PATIENTS WITH KIDNEY TUMORS

Abstract

You have accessJournal of UrologyCME1 May 2022MP24-01 RACE BASED EQUATIONS FOR ESTIMATING KIDNEY FUNCTION MAY CONTRIBUTE TO RACIAL DISPARITIES IN PARTIAL NEPHRECTOMY UTILIZATION AMONG BLACK PATIENTS WITH KIDNEY TUMORS Nour Abdallah, Tarik Benidir, Martin Hofmann, Eiftu Haile, Diego Aguilar Palacios, Venkatesh Krishnamurthi, Samuel Haywood, Mohamed Eltemamy, Jihad Kaouk, Robert Abouassaly, Steven Campbell, and Christopher Weight Nour AbdallahNour Abdallah More articles by this author , Tarik BenidirTarik Benidir More articles by this author , Martin HofmannMartin Hofmann More articles by this author , Eiftu HaileEiftu Haile More articles by this author , Diego Aguilar PalaciosDiego Aguilar Palacios More articles by this author , Venkatesh KrishnamurthiVenkatesh Krishnamurthi More articles by this author , Samuel HaywoodSamuel Haywood More articles by this author , Mohamed EltemamyMohamed Eltemamy More articles by this author , Jihad KaoukJihad Kaouk More articles by this author , Robert AbouassalyRobert Abouassaly More articles by this author , Steven CampbellSteven Campbell More articles by this author , and Christopher WeightChristopher Weight More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002563.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Population based studies have found that black Americans with renal tumors are less likely to undergo a partial nephrectomy (PN) compared to non-black Americans despite their increased risk for chronic kidney disease (CKD). Guidelines suggest assessment of renal function, tumor size and location to determine whether to perform a PN or radical nephrectomy (RN). However, commonly used equations to predict renal function are racialized and estimate a 15-20% higher glomerular filtration rate (eGFR) if the patient is black compared to non-black patients. We hypothesize that these racialized estimates of eGFR may contribute to the lower utilization of PN in blacks. METHODS: From 2005 to 2020, we included 6476 consecutive patients undergoing either PN or RN with known self-reported race and preoperative (preop) creatinine at Cleveland Clinic. Data was dichotomized into Black (n=668) and non-Black patients (n=5808) and compared across preop variables and surgery types. Multivariable regression analysis was used to identify predictors of PN. We also stratified PN rates across CKD stages for blacks and non-blacks. RESULTS: The cohorts’ preop variables are listed in Table 1. Black patients had higher rates of diabetes, hypertension, had higher comorbidity scores and lower baseline eGFR. On multivariable logistic regression analysis, black patients were less likely to be treated via PN (Odds Ratio (OR)=0.75, Confidence interval (CI)=[0.63-0.89], p=0.001), even when controlling for body mass index, age-adjusted Charlson comorbidity index, hypertension, preop eGFR, tumor size and complexity. When comparing PN rates across CKD stages, PN utilization was similar for all stages except stage 1, where the odds of getting a PN were 39% lower for black patients compared to non-blacks (OR 0.61, [0.46-0.82], p=0.01). CONCLUSIONS: Black patients were less likely to undergo PN, despite lower baseline kidney function and higher comorbidity rates. This disparity was most marked in patients with high estimated renal function. Racialized kidney function equations may contribute, along with access and other unknown factors to the disparity seen in the use of kidney preservation strategies for black patients with renal masses. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e392 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nour Abdallah More articles by this author Tarik Benidir More articles by this author Martin Hofmann More articles by this author Eiftu Haile More articles by this author Diego Aguilar Palacios More articles by this author Venkatesh Krishnamurthi More articles by this author Samuel Haywood More articles by this author Mohamed Eltemamy More articles by this author Jihad Kaouk More articles by this author Robert Abouassaly More articles by this author Steven Campbell More articles by this author Christopher Weight More articles by this author Expand All Advertisement PDF downloadLoading ...