ADT May Increase Proteinuria Risk in African-American Men
WASHINGTON, D.C.—African-American race and older age are risk factors for development of proteinuria in men who receive androgen deprivation therapy (ADT) for prostate cancer (PCa), according to data presented at the American Urological Association 2011 annual meeting.
Reza Mehrazin, MD, of the University of Tennessee Health Science Center in Memphis, and colleagues studied 765 PCa patients treated with ADT. The mean age at PCa diagnosis and ADT initiation was 69.8 and 71.2 years, respectively.
Of the 765 patients, 305 (39.9%) were Caucasian and 460 (60.1%) were African American. Subjects had a mean pre-ADT PSA level of 114 ng/mL. During a mean follow-up period of 87.7 months, hypertension, diabetes mellitus, proteinuria, and chronic renal failure developed in 59.8%, 17.9%, 17.1%, and 7.3% of patients, respectively. Length of follow-up and body mass index greater than 30 kg/m2 were the only factors associated with development of hypertension and diabetes mellitus.
Results showed that African American race and older age were significantly associated with development of proteinuria. None of the variables analyzed in the study were associated with a decline in glomerular filtration rate (GFR), as estimated using the Modification of Diet in Renal Disease (MDRD) Study formula, although the researchers observed a small overall mean increase in GFR of 0.30 mL/min/1.73 m2 in the entire cohort following ADT.
These contradictory findings may reflect a loss of muscle mass in these patients, causing serum creatinine to remain stable despite renal deterioration, the investigators explained. Other means of estimating GFR not primarily based on serum creatinine and age may be needed in these patients, they noted.