You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy II (PD11)1 Apr 2020PD11-09 ELEVATED C-REACTIVE PROTEIN IS ASSOCIATED WITH POSTOPERATIVE DEVELOPMENT OF PROTEINURIA AND SUBSEQUENT RENAL FUNCTIONAL DECLINE AND MORTALITY Margaret Meagher*, Zachary Hamilton, Dattatraya Patil, Kazutaka Saiko, Aaron Bradshaw, Sunil Patel, Brittney Cotta, Facundo Davaro-Comas, Yosuke Yasuda, Ahmed Eldefrawy, Fady Ghali, Ryan Nasseri, Fang Wan, Yasuhisa Fujii, Viraj Master, and Ithaar Derweesh Margaret Meagher*Margaret Meagher* More articles by this author , Zachary HamiltonZachary Hamilton More articles by this author , Dattatraya PatilDattatraya Patil More articles by this author , Kazutaka SaikoKazutaka Saiko More articles by this author , Aaron BradshawAaron Bradshaw More articles by this author , Sunil PatelSunil Patel More articles by this author , Brittney CottaBrittney Cotta More articles by this author , Facundo Davaro-ComasFacundo Davaro-Comas More articles by this author , Yosuke YasudaYosuke Yasuda More articles by this author , Ahmed EldefrawyAhmed Eldefrawy More articles by this author , Fady GhaliFady Ghali More articles by this author , Ryan NasseriRyan Nasseri More articles by this author , Fang WanFang Wan More articles by this author , Yasuhisa FujiiYasuhisa Fujii More articles by this author , Viraj MasterViraj Master More articles by this author , and Ithaar DerweeshIthaar Derweesh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000845.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Proteinuria is associated with renal functional decline and may also be a risk factor for mortality, and C-reactive protein (CRP) has been associated with survival outcomes in renal cell carcinoma (RCC). We examined relationship of CRP and proteinuria and renal functional decline in patients with RCC. METHODS: We conducted a multi-institutional retrospective analysis of patients who underwent partial or radical nephrectomy for RCC. Primary outcome was non-cancer mortality (NCM). Secondary outcomes included development of de novo estimated glomerular filtration rate <45 mL/min/m2 (eGFR<45), as well as development of de novo post-operative proteinuria. Multivariate analysis (MVA) was utilized to analyze factors associated with primary and secondary outcomes. Kaplan Meier analysis (KMA) was performed to analyze NCM for patients with or without de novo proteinuria. RESULTS: 2105 patients were analyzed (905 PN/1200 RN). 336 (16%) patients developed de novo post-operative proteinuria. MVA demonstrated African-American race (OR 2.82, p=0.001), radical nephrectomy (OR 1.91, p=0.006), and CRP >0.5 (OR 1.71, p=0.035) as independent risk factors for development of de novo post-operative proteinuria. MVA for development of de novo eGFR <45 revealed increasing age (OR=1.04, p=0.001), African-American race (OR 1.97, p=0.012) and post-operative proteinuria (OR=4.32, p<0.001) as independent risk factors. MVA for NCM revealed increasing age (OR 1.05, p<0.001), male sex (OR 2.73, p=0.005), CRP >0.5 (OR 3.91, p=0.003), and post-operative proteinuria (OR 1.9, p=0.024) as independent risk factors. KMA revealed a significant difference in 5 year survival from NCM between de novo proteinuria and no de novo proteinuria overall (93% vs. 81%, p<0.001) and in stage 1 (94% vs. 85%, p=0.001), stage 2 (88% vs. 75%, p<0.001), and stage 3 RCC (95% vs. 58%, p<0.001) (Figure). CONCLUSIONS: Development of postoperative proteinuria was associated with renal functional decline and non-cancer mortality across stages in RCC patients. Elevation of CRP and African-American race were associated with proteinuria development. Consideration of nephron preserving strategies in patients at risk for postoperative proteinuria should be prioritized when feasible. Source of Funding: Stephen Weissman Kidney Cancer Research Fund © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e257-e257 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Margaret Meagher* More articles by this author Zachary Hamilton More articles by this author Dattatraya Patil More articles by this author Kazutaka Saiko More articles by this author Aaron Bradshaw More articles by this author Sunil Patel More articles by this author Brittney Cotta More articles by this author Facundo Davaro-Comas More articles by this author Yosuke Yasuda More articles by this author Ahmed Eldefrawy More articles by this author Fady Ghali More articles by this author Ryan Nasseri More articles by this author Fang Wan More articles by this author Yasuhisa Fujii More articles by this author Viraj Master More articles by this author Ithaar Derweesh More articles by this author Expand All Advertisement PDF downloadLoading ...