MP27-05 ARE CALCULATED FORMULAS FOR ESTIMATING RENAL FUNCTION ADEQUATE FOR ADMINISTERED CISPLATIN-BASED CHEMOTHERAPY IN SOLITARY RENAL PATIENTS AFTER NEPHROURETERECTOMY FOR UPPER TRACT UROTHELIAL CARCINOMA?

Abstract

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II1 Apr 2016MP27-05 ARE CALCULATED FORMULAS FOR ESTIMATING RENAL FUNCTION ADEQUATE FOR ADMINISTERED CISPLATIN-BASED CHEMOTHERAPY IN SOLITARY RENAL PATIENTS AFTER NEPHROURETERECTOMY FOR UPPER TRACT UROTHELIAL CARCINOMA? Naoya Niwa, Eiji Kikuchi, Masashi Matsushima, Nobuyuki Tanaka, Toru Nishiyama, Akira Miyajima, Shiro Saito, and Mototsugu Oya Naoya NiwaNaoya Niwa More articles by this author , Eiji KikuchiEiji Kikuchi More articles by this author , Masashi MatsushimaMasashi Matsushima More articles by this author , Nobuyuki TanakaNobuyuki Tanaka More articles by this author , Toru NishiyamaToru Nishiyama More articles by this author , Akira MiyajimaAkira Miyajima More articles by this author , Shiro SaitoShiro Saito More articles by this author , and Mototsugu OyaMototsugu Oya More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1036AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The relationship between endogenous creatinine clearance (eCrCl) and formulas for estimating renal function in solitary renal patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU) and subsequent administered cisplatin-based chemotherapy (CBC) have never been evaluated. METHODS Between 2000 and 2012, 60 patients who received CBC for locally invasive or metastatic UTUC after RNU were retrospectively identified. The eCrCl was measured based on 24-hour urine specimens immediately prior to each cycle of chemotherapy. Renal function was also estimated with 4 different formulas: Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and Wright formula. We evaluated the relationship between eCrCl and each formula using kappa statistics. Kappa statistic was used at a cut-off of 60 ml/min for eCrCl or estimated renal function. RESULTS The median age was 72 years and 46 (76.7%) were male. Thirty-seven patients (61.7%) received more than 3 cycles of CBC. The median eCrCl was 53.9 ml/min, and the median CG, MDRD, CKD-EPI, and Wright were 43.3, 52.3, 51.2, and 55.5 ml/min, respectively. The kappa statistics between eCrCl and CG, MDRD, CKD-EPI, and Wright at the first cycle of the 60 patients was 0.29, 0.37, 0.49, and 0.67, respectively. The kappa statistics between eCrCl and Wright was the highest. A total of 256 cycles of CBC were administered to 60 patients. The kappa statistics between eCrCl and CG, MDRD, CKD-EPI, and Wright in overall 256 cycles was 0.34, 0.46, 0.53, and 0.57, respectively. The kappa statistics between eCrCl and Wright was also the highest. Among patients with an eCrCl of 60 ml/min, 70%, 60%, 50%, and 20% of patients were underestimated to have <60 ml/min by CG, MDRD, CKD-EPI, and the Wright formula, respectively. The mean values of eCrCl immediately prior to the first, second, and third cycles of CBC in 37 patients treated with more than 3 cycles of CBC were 59.4, 54.6, and 54.5 ml/min, respectively, with no significant difference being observed over the chemotherapy course. Similar results were also observed using the Wright formula (59.7, 58.6, and 58.4 at the first, second, and third cycles of CBC, respectively). CONCLUSIONS Renal function estimated by the 4 different formulas may underestimate eCrCl in patients administered CBC after RNU. Of the 4 formulas, the Wright formula was the most closely associated with eCrCl. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e363-e364 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Naoya Niwa More articles by this author Eiji Kikuchi More articles by this author Masashi Matsushima More articles by this author Nobuyuki Tanaka More articles by this author Toru Nishiyama More articles by this author Akira Miyajima More articles by this author Shiro Saito More articles by this author Mototsugu Oya More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...