{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T03:26:11Z","timestamp":1793676371046,"version":"4.5.1"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"13","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Klinikum der Universit\u00e4t M\u00fcnchen","id":[{"id":"https:\/\/ror.org\/05591te55","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2026,11]]},"abstract":"Abstract<\/jats:title>\n \n Purpose<\/jats:title>\n \n Renal toxicity after peptide receptor radionuclide therapy (PRRT) is commonly assessed using Common Terminology Criteria for Adverse Events (CTCAE), whereas nephrological classification relies on Kidney Disease: Improving Global Outcomes (KDIGO)-based renal function categories. We compared CTCAE- and KDIGO-derived eGFR\n cr<\/jats:sub>\n -based definitions of renal function deterioration after PRRT and evaluated their predictive value for subsequent long-term renal outcome.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n 149 gastroenteropancreatic neuroendocrine tumor patients scheduled for PRRT with renal follow-up for at least 12 months after treatment were included. Kidney function was assessed at baseline (BL), after the last cycle (LC) and last available follow-up (FU). Analyzing the time interval from BL to LC, estimated glomerular filtration rate (eGFR\n cr<\/jats:sub>\n )-based KDIGO and CTCAE classifications along with risk factors for recategorization were compared. Clinically relevant KDIGO worsening was defined according to KDIGO 2012 (eGFR\n cr<\/jats:sub>\n category worsening with an additional eGFR\n cr<\/jats:sub>\n decline\u2009\u2265\u200925%).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Median eGFR\n cr<\/jats:sub>\n declined from 87 to 68 mL\/min\/1.73\u00a0m\u00b2 over a median follow-up of 2.2 years (\n p<\/jats:italic>\n \u2009<\u20090.0001). From BL to FU, clinically relevant KDIGO worsening was substantially discordant from CTCAE eGFR\n cr<\/jats:sub>\n grading (KDIGO-\/CTCAE+: 21 vs. KDIGO+\/CTCAE-: 2;\n p<\/jats:italic>\n \u2009<\u20090.0001). In multivariable analysis, age (\n p<\/jats:italic>\n \u2009=\u20090.0125) and cumulative activity (\n p<\/jats:italic>\n \u2009=\u20090.0205) were associated with clinically relevant KDIGO worsening (CTCAE eGFR\n cr<\/jats:sub>\n worsening: age,\n p<\/jats:italic>\n \u2009<\u20090.0209). Early CTCAE eGFR\n cr<\/jats:sub>\n worsening during BL to LC predicted subsequent annualized eGFR decline until further FU (\u03b2\u2009\u2212\u20096.82; 95% CI\u2009\u2212\u200910.06 to \u2212\u20093.57;\n p<\/jats:italic>\n \u2009<\u20090.0001). Both clinically relevant KDIGO eGFR\n cr<\/jats:sub>\n worsening and absolute eGFR\n cr<\/jats:sub>\n at LC, however, failed to reach significance for long-term outcome prediction of renal function (\n p<\/jats:italic>\n \u2009>\u20090.05, each).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n For evaluation of renal safety under PRRT, clinically relevant KDIGO deterioration and CTCAE grading are not interchangeable. Clinically relevant KDIGO-derived eGFR\n cr<\/jats:sub>\n worsening represents a stricter filtration-based endpoint, whereas early CTCAE eGFR\n cr<\/jats:sub>\n worsening may help identify patients requiring closer post-treatment renal surveillance. Prospective studies integrating serial filtration markers, urine biomarkers, measured GFR, and individualized kidney dosimetry are warranted, especially in light of current ongoing trials investigating PRRT being moved to an earlier stage in the treatment course.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1007\/s00259-026-08126-4","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T03:31:39Z","timestamp":1786505499000},"page":"8272-8283","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative assessment of KDIGO and CTCAE criteria for detecting renal function deterioration after peptide receptor radionuclide therapy"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3175-952X","authenticated-orcid":false,"given":"Sophie C.","family":"Siegmund","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Salem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elma","family":"Dema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liam","family":"Widjaja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz Josef","family":"Gildehaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Spitzweg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph J.","family":"Auernhammer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Brendel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolf A.","family":"Werner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"8126_CR1","doi-asserted-by":"publisher","first-page":"1752","DOI":"10.1016\/s1470-2045(21)00572-6","volume":"22","author":"JR Strosberg","year":"2021","unstructured":"Strosberg JR, Caplin ME, Kunz PL, Ruszniewski PB, Bodei L, Hendifar A, et al. 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After using this tool\/service, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.","order":3,"name":"Ethics","label":"Declaration of generative AI and AI-assisted technologies in the writing process<\/b>","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"RAW: speaker honoraria for Novartis\/AAA. MB is a member of the Neuroimaging Committee of the EANM. MB has received speaker honoraria from Roche, GE Healthcare, Iba, Miltenyi, and Life Molecular Imaging; has advised Life Molecular Imaging, MIAC, Cenos, and GE healthcare; and is currently on the advisory or imaging review boards of AC Immune and ZRO Imaging.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}