Abstracts from the Mid-Atlantic Section of the AUA 2020

MA AUA 2020 Abstracts Nephrology Referral Practices Surrounding Renal Cancer Surgery J. Wainger; J. Cheaib; H. Patel; M. Huang; M. Biles; M. Metcalf; J. Canner; M. Johnson; M. Allaf; P. Pierorazio Johns Hopkins University, Baltimore, MD, USA Introduction: Data are limited describing nephrology referral for patients at-risk for CKD per 2017American UrologicAssociation guidelines. We examined nephrology referral rates amongst renal cancer nephrectomy patients to assess referral predictors and study associations of nephrology referral and survival. Materials & Methods: We obtained data from the SEER-Medicare database for patients ≥66 years oldwho received nephrectomies for malignancy from 1999-2014. Referral data were based on nephrology claims. We identified if and when patients were referred by CKD disease status and surgery type, used logistic regression to identify associated patient factors and used a Cox proportional hazard regression model to assess associations with survival. Logistic regression and survival analyses were conducted for cases from 2004-2014 with available comorbidity data. Results: There were a total of 25,641 subjects who met criteria for analysis; 20,641 of them receiving radical nephrectomy and 5,010 patients receiving partial nephrectomy (PN). Median follow-up time for patients receiving radical and partial nephrectomy was 26.1 and 40.4 months respectively. Data on referral patterns are for radical nephrectomy patients are shown in Figure 1. Data on predictors of referral are shown in Table 1. Conclusions: Few renal cancer patients at risk for CKDprogression or development present with an established nephrologist or receive pre-operative referral, suggesting missed opportunities to refer high risk patients. Pre-operative referral does not appear to improve survival; however, referred patients may represent a higher risk subset, and other patients who may benefit appear under-referred. MP4-09 Poster Session 4: Oncology Treatment and Outcomes 33