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UPJ INSIGHT Non–race-based Glomerular Filtration Rates to Estimate Renal Functional Outcomes Following Nephrectomy
By: Cameron J. Britton, MD, Mayo Clinic, Rochester, Minnesota; Vidit Sharma, MD, Mayo Clinic, Rochester, Minnesota; Christine M. Lohse, MS, Mayo Clinic, Rochester, Minnesota; R. Houston Thompson, MD, Mayo Clinic, Rochester, Minnesota; John C. Lieske, MD, Mayo Clinic, Rochester, Minnesota; Andrew D. Rule, MD, Mayo Clinic, Rochester, Minnesota; Aaron M. Potretzke, MD, Mayo Clinic, Rochester, Minnesota | Posted on: 18 May 2023
Britton CJ, Sharma V, Lohse CM, et al. Non–race-based glomerular filtration rates to estimate renal functional outcomes following radical and partial nephrectomy. Urol Pract. 2023;10(3):212-216.
Study Need and Importance
The gold standard for management of localized renal malignancy remains surgical resection. Renal function can be estimated using serum markers such as creatinine. Functional decline following radical and partial nephrectomy is an important consideration for providers. National organizations have recommended movement away from glomerular filtration rate (GFR) equations which use racial variables. Because of this shift in practice, these formulas require validation for predicting GFR postoperatively.
What We Found
We examined non–race-based formulas for estimating preoperative GFR and predicting short- and long-term renal function outcomes following radical and partial nephrectomy. These equations do not significantly alter predictive ability for estimated GFR (eGFR) in the postoperative setting. However, utilizing non–race-based formulas led to a decrease in eGFR for Black patients and an increase in eGFR estimation for non-Black patients (see Figure).
Limitations
The main limitation of our work is the limited number of Black patients analyzed. Future studies with larger cohorts will be needed to validate these findings and provide generalizability to more diverse populations.
Interpretation for Patient Care
Our findings demonstrate limited changes to predicted renal functional outcomes following partial and radical nephrectomy for localized renal malignancy. In light of the recommendations from national organizations, providers can be reassured that non–race-based formulas provide accurate assessment of predicted postoperative renal function.
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