MP47-03 THE CKD-EPI EQUATION IS THE MOST ACCURATE MODEL TO DETECT IMPAIRED RENAL FUNCTION PRIOR AND AFTER RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive IV1 Apr 2018MP47-03 THE CKD-EPI EQUATION IS THE MOST ACCURATE MODEL TO DETECT IMPAIRED RENAL FUNCTION PRIOR AND AFTER RADICAL CYSTECTOMY Matthias Meunier, Mathieu Rouanne, Aurélie Mbeutcha, Yann Neuzillet, Henry Botto, Marie Courbebaisse, and Thierry Lebret Matthias MeunierMatthias Meunier More articles by this author , Mathieu RouanneMathieu Rouanne More articles by this author , Aurélie MbeutchaAurélie Mbeutcha More articles by this author , Yann NeuzilletYann Neuzillet More articles by this author , Henry BottoHenry Botto More articles by this author , Marie CourbebaisseMarie Courbebaisse More articles by this author , and Thierry LebretThierry Lebret More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1482AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Determination of glomerular function rate (GFR) is essential for the management of patients with invasive bladder cancer. However, the best method to estimate GFR in patients selected for radical cystectomy is unknown. Our aim was to characterize the most accurate and least biased method. METHODS We prospectively included patients with invasive bladder cancer selected for radical cystectomy and urinary diversion. Measured isotopic GFR (iGFR) by 51Cr-EDTA and estimated GFR (eGFR) by Cockroft and Gault, MDRD and CKD-EPI formulas were performed before and 6 months after radical cystectomy. Bias and precision of eGFR were compared with iGFR at each time point. Sensitivity (Sn), specificity (Sp) and ROC curves were calculated and compared. RESULTS Twenty-seven patients (median age 69 yrs) were included. Median iGFR decreased from 85.1 mL/min/1.73m2 to 69.9 mL/min/1.73m2 6 months after surgery (p<0.001). At preoperative and postoperative time, CKD-EPI produced the smallest bias for agreement (median agreement: CKD-EPI 6.588±7.97 CI95%[3.369-9.808]; CG -0.396±13.676 CI95%[-5.920-5.128]; MDRD 7.396±16.177 CI95%[0.862-13.930]) and the highest correlation coefficient (CKD-EPI r=0,92, p<1.10-10; CG r=0.76, p<1.10-5; MDRD r=0,83, p<1.10-6) compared with iGFR. Sn and Sp to predict deteriorating renal function for each equation were respectively: CG Sn=0.824-Sp=0.400 (AUC=0.612, CI95%[0.426-0.797], p=0.237); MDRD Sn=0.647-Sp=0.700 (AUC=0.674, CI95%[0.483-0.864], p=0.074); CKD-EPI Sn=0.706-Sp=0.900 (AUC=0.803, CI 95%[0.654-0.951], p<0.0001). CONCLUSIONS In our prospective series, CKD-EPI was the most accurate equation to predict pre and postoperative GFR and to accurately estimate GFR decline after radical cystectomy. Both findings strengthen the need to harmonize GFR assessment in bladder cancer patients selected for radical cystectomy. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e615-e616 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Matthias Meunier More articles by this author Mathieu Rouanne More articles by this author Aurélie Mbeutcha More articles by this author Yann Neuzillet More articles by this author Henry Botto More articles by this author Marie Courbebaisse More articles by this author Thierry Lebret More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...