title: Prevalence of baseline chronic kidney disease in patients presenting with solid renal tumors.
abstract: OBJECTIVE
  To evaluate the prevalence of baseline chronic kidney disease (CKD) in a large cohort of patients presenting with renal masses to a tertiary care center, comparing serum creatinine (sCr) and estimated glomerular filtration rate (eGFR). sCr inadequately reflects renal function. eGFR and chronic kidney disease CKD stage are more clinically relevant parameters to reflect the risk of morbidity and mortality in patients after nephron loss.
  
  
  METHODS
  Using the prospectively maintained Fox Chase Kidney Cancer Database, we identified patients undergoing kidney surgery between January 2000 and May 2010. eGFR was calculated using the Modification of Diet in Renal Disease (MDRD) and the CKD-Epidemiology formulas. CKD stages I-V were defined using the National Kidney Foundation definitions.
  
  
  RESULTS
  A total of 1114 patients had adequate data available to calculate a preoperative eGFR (mL/min). Although 88% of all patients presenting for surgery at our institution had a "normal" baseline sCr (≤1.4 mg/dL), 22% of patients had CKD stage III or greater. Moreover, of the 282 patients 70 years and older, 40% (113/282) had CKD stage III. Twenty-three percent (51/220) of patients older than 70 years had CKD stage III with a seemingly normal sCr.
  
  
  CONCLUSIONS
  Many patients with a normal sCr have CKD stage III or higher, particularly patients older than 70 years old. Given the high prevalence of baseline CKD in patients with a solid renal tumor, a concerted effort must be made to preserve renal function when surgically treating solid renal masses.
authors.affiliation: Department of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA. danieljcanter@gmail.com
authors.forename: Daniel
authors.initials: D
authors.lastname: Canter
authors.forename: Alexander
authors.initials: A
authors.lastname: Kutikov
authors.forename: Mohit
authors.initials: M
authors.lastname: Sirohi
authors.forename: Ryan
authors.initials: R
authors.lastname: Street
authors.forename: Rosalia
authors.initials: R
authors.lastname: Viterbo
authors.forename: David Y T
authors.initials: DY
authors.lastname: Chen
authors.forename: Richard E
authors.initials: RE
authors.lastname: Greenberg
authors.forename: Robert G
authors.initials: RG
authors.lastname: Uzzo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D007680:Kidney Neoplasms / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D015995:Prevalence; D055815:Young Adult
chemical_list: D003404:Creatinine