EGFR TRAJECTORIES IN IRAQI CANCER PATIENTS AT FIRST PRESENTATION

Introduction:

The intersection between chronic kidney disease (CKD) and cancer is complex, and the rising onconephrology specialty is the best example of such an intricate relationship. Different cohorts of patients with solid tumors revealed variable prevalence of stage 3 CKD. In 2022, the Global Cancer Observatory reported that the age-standardized rate in Iraq is 136.6, with breast cancer being the most prevalent cancer. 

The objective of this study is to know the trajectories of eGFR, and then the incidence of CKD in a cohort of adult Iraqi cancer patients who presented for the first time with cancer diagnosis.

Methods:

We analyzed a cohort of 513 adult cancer patients referred to the largest oncology center in Baghdad over six months (January – July 2024) and tested for serum creatinine. The eGFR was calculated using the CKD-EPI 2009 equation. Then, the cohort was categorized according to the CKD staging. Patients with a previously documented diagnosis of CKD, those who are receiving kidney replacement therapy, and kidney transplant recipients were excluded. Patients with missing data were omitted.

Results:

The mean age of the study group is 54 + 14 years, with 343 (67%) females. Cardiovascular risk factors were present in 212 patients (41.3%). There were 504 (98%) solid malignancies and nine hematological malignancies. Breast cancer constituted 193 patients (37.6%), while urinary tract cancers constituted 53 patients (10.3%). The mean creatinine of the study group was 0.83+0.48 mg/dl, and the mean eGFR was 94.5+26.7 ml/min/1.73m2. 11.1% of patients had an eGFR of < 60 ml/min/1.73m2, and 24.2% were below 90 ml/min/1.73m2. All urinary tract cancers (Kidney, Bladder, and prostate) were associated with an eGFR below 90 ml/min/1.73m2. Renal cell carcinoma was associated with the lowest mean eGFR of 71.9 ml/min/1.73m2.

Conclusions:

Twenty-four percent of Iraqi cancer patients have variable degrees of CKD, according to eGFR, at their first presentation to oncology services. An eGFR below 60 ml/min/1.73m2 presents in 11%. Longitudinal studies with larger samples are mandatory. Accordingly, a dedicated onco-nephrology team should be needed to provide the best medical care for these patients.  

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.