MP73-08 PROTEINURIA IN PATIENTS UNDERGOING RENAL CANCER SURGERY: IMPACT ON OVERALL SURVIVAL AND STABILITY OF RENAL FUNCTION

Abstract

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging I1 Apr 2016MP73-08 PROTEINURIA IN PATIENTS UNDERGOING RENAL CANCER SURGERY: IMPACT ON OVERALL SURVIVAL AND STABILITY OF RENAL FUNCTION Zhiling Zhang, Juping Zhao, Joseph Zabell, Erick Remer, Jianbo Li, Jack A. Campbell, Wen Dong, Diego Aguilar Palacios, Tulsi Patel, Sevag Demirjian, and Steven C. Campbell Zhiling ZhangZhiling Zhang More articles by this author , Juping ZhaoJuping Zhao More articles by this author , Joseph ZabellJoseph Zabell More articles by this author , Erick RemerErick Remer More articles by this author , Jianbo LiJianbo Li More articles by this author , Jack A. CampbellJack A. Campbell More articles by this author , Wen DongWen Dong More articles by this author , Diego Aguilar PalaciosDiego Aguilar Palacios More articles by this author , Tulsi PatelTulsi Patel More articles by this author , Sevag DemirjianSevag Demirjian More articles by this author , and Steven C. CampbellSteven C. Campbell More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1663AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Proteinuria is has recently been included into Kidney Disease: Improving Global Outcomes (KDIGO) risk stratification of chronic kidney disease (CKD) in the general population. However, the importance of proteinuria in patients with renal cancer has not been well studied. We sought to evaluate the prognostic impact of preoperative proteinuria on overall survival (OS) and stability of renal function (SRF) for patients managed with renal cancer surgery. METHODS From 1999-2008, 977 patients underwent renal cancer surgery with recorded preoperative estimated glomerular filtration rate (eGFR) based on CKD epidemiology collaboration (CKD-EPI) equations (G1:>90ml/min/1.73m2; G2:60-89; G3a:45-59; G3b:30-44; G4:15-29; G5<15) and proteinuria status based on dipstick (ANEG:negative/trace or APOS>30mg/dL). Median follow-up was 8.7(7.0-10.7) years. OS and SRF (avoidance of 50% or greater GFR decline and avoidance of dialysis) were analyzed using Kaplan-Meier. Multivariable Cox regression evaluated for independent predictors for both outcomes. RESULTS APOS was found in 326 patients (33%), and these patients had decreased 5-year OS compared with ANEG (65% vs. 77%, p<0.001). They also demonstrated reduced SRF at 5 years (72% vs. 86%, p<0.001). However, significant differences in OS based on proteinuria were only observed in the G1, G2, and G3a groups, and differences in SRF in G3a. On multivariable analysis for all patients or those with G1/G2/G3a, proteinuria was an independent prognosticator for OS(both p< 0.05). On multivariable analysis for all patients or those with G3a, proteinuria was an independent prognosticator for decreased SRF(both p< 0.05). Limitations include retrospective design and potential ascertainment bias. CONCLUSIONS Proteinuria appears to be a significant and independent predictor of decreased OS and SRF in patients undergoing renal cancer surgery, particularly certain cohorts, and should be sensibly incorporated into routine clinical management. Further studies, ideally prospective, will be required to evaluate the importance of degree of proteinuria, and the generalizability of our findings. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e963 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Zhiling Zhang More articles by this author Juping Zhao More articles by this author Joseph Zabell More articles by this author Erick Remer More articles by this author Jianbo Li More articles by this author Jack A. Campbell More articles by this author Wen Dong More articles by this author Diego Aguilar Palacios More articles by this author Tulsi Patel More articles by this author Sevag Demirjian More articles by this author Steven C. Campbell More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...