Estimated glomerular filtration rate reduces cost and patient burden in partial nephrectomy trials

A recent study found that estimated glomerular filtration rate (eGFR) can replace measured GFR (mGFR) in partial nephrectomy (PN) trials as it helps reduce cost and patient burden. This study was published in the journal, BJU International.

This post hoc analysis of the renal hypothermia trial included 183 patients who underwent mGFR with diethylenetriaminepentaacetic acid (DTPA) plasma clearance preoperatively and 1-year post PN. Using the 2009 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equations incorporating age and sex, with and without race: 2009 eGFRcr (ASR) and 2009 eGFRcr (AS), and 2021 eGFRcr (AS), the 2021 equation that only considers age and sex; the eGFR was calculated.  Performance was evaluated on the basis of median bias, precision, and accuracy.

It was observed that the pre- and postoperative median bias and precision were similar between the 2009 eGFRcr (ASR) and 2009 eGFRcr (AS).  Bias and precision were worse for 2021 eGFRcr (AS). Similarly, pre- and postoperative accuracy was >90% for the 2009 eGFRcr (ASR) and 2009 eGFRcr (AS) equations while accuracy was 78.6% preoperatively and 66.5% postoperatively for 2021 eGFRcr (AS).[SB1] 

From the above results, it can be concluded that 2009 eGFRcr (AS) can accurately estimate GFR in PN trials and may replace mGFR to reduce cost and patient burden.