Mp70-01 Evaluating the Impact of New CKD-Epi Creatinine Equation (2021) for Egfr on the Management of Muscle Invasive Bladder Cancer

You have accessJournal of UrologyDiversity, Equity & Inclusion: Health Equity & Outcomes III (MP70)1 May 2024MP70-01 EVALUATING THE IMPACT OF NEW CKD-EPI CREATININE EQUATION (2021) FOR EGFR ON THE MANAGEMENT OF MUSCLE INVASIVE BLADDER CANCER Amir Khan and Mohummad Minhaj Siddiqui Amir KhanAmir Khan and Mohummad Minhaj SiddiquiMohummad Minhaj Siddiqui View All Author Informationhttps://doi.org/10.1097/01.JU.0001008796.84999.75.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In September 2021, the National Kidney Foundation and American Society of Nephrology Task Force announced a new race-free calculation for estimated glomerular filtration rate (eGFR). Aspects of treatment decisions for muscle invasive bladder cancer (MIBC) such as neoadjuvant cisplatin (NAC) eligibility and choice of diversion with cystectomy are dependent on eGFR. Herein, we evaluate the impact of new CKD-EPI creatinine equation on the eligibility for Neoadjuvant Cisplatin based chemotherapy in MIBC patients. METHODS: Using the National Surgical Quality Improvement Program (NSQIP) database, patients (>18 years) who received radical cystectomy from 2006 to 2020 and were postoperatively diagnosed with MIBC were included in this study. eGFR was calculated using the Modification of Diet in Renal Disease (MDRD) equation and the CKD-EPI Creatinine Equation (2021). Patients with missing data on age, creatinine, sex, and race were excluded. We calculated the proportion of patients (Black and Non-Black) who were candidates for Neoadjuvant Cisplatin based Chemotherapy using eGFR ≥60 ml/min/1.73 m2 as the cutoff. McNemar test and paired t-test were employed to find the significance for change in proportions and mean eGFR, respectively. Statistical significance was set at p-value <0.05. RESULTS: Among a total of 15,249 patients, Black cohort constituted 5.46% (832) while non-Black cohort constituted 94.54% (14,417). CKD-EPI Creatinine Equation (2021) calculated a decrease in the mean eGFR for Black patients, 63.22 ml/min/1.73 m2 compared to 70.66 ml/min/1.73 m2 as calculated using the MDRD equation (p value <0.0001). However, for non-Black cohort the CKD-EPI Creatinine Equation (2021) calculated an increase in the mean eGFR, 70.66 ml/min/1.73 m2 compared to 66.63 ml/min/1.73 m2 using MDRD equation (p value <0.0001). Furthermore, using the CKD-EPI Creatinine Equation (2021) 7.8% (n=1,119) more non-Black patients become eligible for NAC (p value <0.0001), however, for Black cohort, the NAC eligible proportion decreased by 8.5% (n=71 and p value <0.0001) Figure 1. CONCLUSIONS: Opting the CKD-EPI Creatinine Equation (2021) will preclude some of the previously eligible Black patients from NAC for MIBC management but contrarily will increase the non-Black patients' eligible proportion for NAC. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1128 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Amir Khan More articles by this author Mohummad Minhaj Siddiqui More articles by this author Expand All Advertisement PDF downloadLoading ...