Changes in Renal Function of Patients With Prostate Cancer: Focus on Androgen Deprivation Therapy.

ABSTRACT

BACKGROUND/AIM: To investigate the association between androgen deprivation therapy (ADT) and changes in the estimated glomerular filtration rate (eGFR) in male Japanese patients with prostate cancer, based on post-hoc analysis of data from a previous prospective study. PATIENTS AND METHODS: Among 103 patients with prostate cancer in whom renal function changes were tracked over 5 years, 88 were divided into a group who completed ADT within 3 years (short ADT group; n=47) and a group who continued with ADT for more than 5 years (continuous ADT group; n=41). We compared the groups in terms of the eGFR, calculated based on age and serum creatinine (mg/dl) before ADT initiation and every other year over the next 5 years. RESULTS: The eGFR decreased by 4.91 and 2.89 ml/min in the short and continuous ADT groups, respectively, over the 5-year period following ADT initiation. The respective decreases in the eGFR were 0.98 and 0.58 ml/min/year. No significant difference in the eGFR was observed between the two groups at any measurement point. Patients treated with ADT showed a decrease in the eGFR of 0.58-0.98 ml/min/year over a 5-year period, which is about twice as high as that of normal Japanese males. No significant difference in the eGFR by ADT duration was observed. CONCLUSION: The eGFR decreased by 0.58-0.98 ml/min/year in our ADT patients, which was about twice as high as the rate of decrease in normal Japanese males, and approximately the same as in urine protein-positive male patients. We suggest that a large decrease in the eGFR may not play a role in the development of acute kidney injury. In addition, the duration of ADT does not appear to have a significant effect on the eGFR.