Renal function by egfr calculators in prune belly syndrome and posterior urethral valves

You have accessJournal of UrologyCME1 Apr 2023MP53-14 RENAL FUNCTION BY EGFR CALCULATORS IN PRUNE BELLY SYNDROME AND POSTERIOR URETHRAL VALVES Alexandra Carolan, Shane Batie, Samuel Gold, Shaheer Ali, Daniel Wong, Nida Karra, Nathalia Amado, Jyothsna Gattineni, Bruce Schlomer, Yvonne Chan, and Linda Baker Alexandra CarolanAlexandra Carolan More articles by this author , Shane BatieShane Batie More articles by this author , Samuel GoldSamuel Gold More articles by this author , Shaheer AliShaheer Ali More articles by this author , Daniel WongDaniel Wong More articles by this author , Nida KarraNida Karra More articles by this author , Nathalia AmadoNathalia Amado More articles by this author , Jyothsna GattineniJyothsna Gattineni More articles by this author , Bruce SchlomerBruce Schlomer More articles by this author , Yvonne ChanYvonne Chan More articles by this author , and Linda BakerLinda Baker More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003301.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In prune belly syndrome (PBS), prior comparison of estimated glomerular filtration rate (eGFR) with calculators using creatinine (Cr) and/or Cystatin C (Cys) showed lower mean eGFR with Cys-based calculators than with the “Bedside Schwartz” Cr-based calculator (eGFRcr) in Chronic Kidney Disease (CKD) 1 and 2. As abdominal skeletal muscle paucity in PBS could reduce serum Cr, we hypothesized the differences in mean eGFRcr and eGFR by Cys-based calculators (denoted as Δ) will be greater in PBS compared to posterior urethral valves (PUV), with intact musculature. METHODS: A 2014-2021 retrospective ICD-10 search identified PBS and PUV patients with labs and height without neuromuscular disorders or renal replacement. eGFRcr, eGFRcys and creatinine-cystatin C-based GFR (eGFR-CKiD) were calculated. CKD stages were assigned by eGFRcr. Δ eGFRcr, eGFRcys, and eGFR-CKiD between PBS and PUV were compared with t-test. Those with normal Cr and/or Cys but who had CKD by eGFR calculators were identified. The proportion of changes in CKD staging by each calculator was compared with chi-square or Fishers exact test. RESULTS: 95 PUV and 26 PBS patients were analyzed (Figure 1). Δ eGFRCr and eGFR with Cys-based calculators by CKD stage or by all CKD stages combined were not different between PBS and PUV. By all CKD stages combined, Δ eGFRcr and eGFRcys was 18 and 13 mL/min/1.73 m2 in PBS and PUV, respectively (p=0.22) and Δ eGFRcr and eGFR-CKiD was 8 and 5 ml/min/1.73 m2 in PBS and PUV, respectively (p=0.71). Among patients with normal Cr and/or Cys, at least 25% had CKD2-3 by eGFR calculation. Changes in CKD stage by Cys-based calculators compared to eGFRcr were not significantly different between PBS and PUV (p>0.3). Upstaging was most frequent in PBS and PUV CKD1 and 2. CONCLUSIONS: Differences between eGFRcr and eGFR by Cys-based calculators in PBS and PUV patients were not significant, suggesting paucity of abdominal musculature in PBS may not account for the lower eGFRs observed using Cys-based calculators. In 25% of patients, normal Cr and/or Cys actually had CKD2-3, highlighting importance of eGFR calculation. Cys-based calculators upstaged, especially in CKD1 and 2. Cys-based eGFRs calculators should be considered for early identification of CKD in patients with congenital urologic abnormalities prone to renal dysfunction. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e717 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexandra Carolan More articles by this author Shane Batie More articles by this author Samuel Gold More articles by this author Shaheer Ali More articles by this author Daniel Wong More articles by this author Nida Karra More articles by this author Nathalia Amado More articles by this author Jyothsna Gattineni More articles by this author Bruce Schlomer More articles by this author Yvonne Chan More articles by this author Linda Baker More articles by this author Expand All Advertisement PDF downloadLoading ...