eGFR can replace measured GFR in nephrectomy trials: clinical implications

What is it about?

This study compares the estimated glomerular filtration rate (eGFR) using three different Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations to measured glomerular filtration rate (mGFR) in patients undergoing partial nephrectomy (PN). The 2009 eGFRcr(ASR) equation was found to accurately estimate glomerular filtration rate (GFR) in this population, with an overall percent difference within 30% of mGFR of >90%. The 2021 eGFRcr(AS) equation significantly underestimated mGFR, with a median bias of -8.8 mL/min/1.73 m^2 preoperatively and -12.0 mL/min/1.73 m^2 postoperatively. The use of eGFR in PN trials instead of mGFR would significantly improve feasibility, as eGFR is a more convenient and less costly test for patients.

Featured Image

Why is it important?

This research is important because it assesses the feasibility of using estimated glomerular filtration rate (eGFR) as a replacement for measured glomerular filtration rate (mGFR) in partial nephrectomy (PN) trials. The eGFR is a spot laboratory test that is more convenient and less costly for patients compared to mGFR, which requires an injection of an exogenous marker and serial blood draws over time. Accurate estimation of GFR is crucial in renal surgery studies as it is an essential factor in assessing the outcomes of the surgery. Key Takeaways: 1. The 2009 eGFRcr(AS) was found to accurately estimate GFR in patients undergoing PN. 2. The 2021 eGFRcr(AS) significantly underestimated mGFR and had poor accuracy. 3. The use of eGFR in PN trials could improve feasibility and reduce patient burden. 4. Further research is needed to identify the optimal eGFR equation, particularly in specific subgroups and in patients identifying as Black.