Proteinuria is a predictor for renal functional decline in patients with kidney cancer, a study published in The Journal of Urology has shown.1
Although prior studies have demonstrated that 26% to 34% of patients with suspected kidney cancers have a glomerular filtration rate (GFR) less than 60 mL/min/1.73 m2, there are limited data on the incidence of proteinuria. Therefore, researchers sought to investigate the extent of proteinuria in patients with kidney cancer to determine the impact on classification and progression of chronic kidney disease (CKD).
For the study, researchers analyzed data from 1622 patients who were evaluated between 1999 and 2014. Of those, 1016 had both preoperative creatinine and proteinuria measurements available.
Researchers found that prior to treatment, 32% had a GFR less than 60 and 22% had preoperative proteinuria, which was detected in 30% of those with reduced GFR and 18% with normal GFR.
Further, 44% of patients were determined to be at increased risk for CKD progression, of which 24%, 12%, and 8% were at moderately-increased, high, and very-high risk, respectively. The presence of proteinuria reclassified 25% with stage 3 CKD as high or very-high risk.
Results showed that the 2012 KDIGO guidelines classification predicted renal functional decline, which occurred in 2.2%, 4.4%, 9.4%, and 34.6% at 3 years in low, moderately-increased, high, and very-high risk categories, respectively.
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The key predictors of renal functional decline were KDIGO classification group, tumor size, and radical nephrectomy (each P<.0001), while age and tumor size predicted for KDIGO group (each P<.001).
- O’Donnell K, Tourojman M, Tobert CM, et al. Proteinuria is a predictor of renal functional decline in kidney cancer patients [published online ahead of print March 23, 2016]. J Urol. doi: 10.1016/j.juro.2016.03.134.