Prevalence of renal insufficiency in elderly cancer patients in a tertiary cancer center

Abstract

Objective To estimate the prevalence of abnormal glomerular filtration rate in elderly patients with solid tumors.Methods A retrospective study with patients aged >65 years diagnosed with solid tumors between January 2007 and December 2011 in a cancer center. The following data were collected: sex, age, serum creatinine at the time of diagnosis and type of tumor. Renal function was calculated using abbreviated Modification of Diet in Renal Disease (MDRD) formulae and then staged in accordance with the clinical practice guidelines published by the Working Group of the National Kidney Foundation.Results A total of 666 patients were included and 60% were male. The median age was 74.2 years (range: 65 to 99 years). The most prevalent diagnosis in the study population were colorectal (24%), prostate (20%), breast (16%) and lung cancer (16%). The prevalence of elevated serum creatinine (>1.0mg/dL) was 30%. However, when patients were assessed using abbreviated MDRD formulae, 66% had abnormal renal function, stratified as follows: 45% with stage 2, 18% with stage 3, 3% with stage 4 and 0.3% with stage 5.Conclusion To the best of our knowledge, this was the first study to estimate the frequency of renal insufficiency in elderly cancer patients in Brazil. The prevalence of abnormal renal function among our cohort was high. As suspected, the absolute creatinine level does underestimate renal function impairment and should not be used as predictor of chemotherapy metabolism, excretion and consequent toxicity.

Severe Oral Mucositis in Pediatric Cancer Patients: Survival Analysis and Predictive Factors

“…A study that analyzed 666 patients with solid tumors found a high prevalence of an abnormal glomerular filtration rate [39]. In another study conducted on patients with kidney failure receiving melphalan-a stomatotoxic drug used for treatment of multiple myeloma-the severity of oral mucositis increased with high-dose chemotherapy, as drug elimination was impaired due to the patients' abnormal kidney function [37].…”

Renal Function and All-Cause Mortality Risk Among Cancer Patients

“…Several previous studies have demonstrated that renal dysfunction occur frequently in patients with cancer. 9 – 12 The renal insufficiency and anticancer medications (IRMA) study showed that 52.9% exhibited an estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m 2 , calculated according to the Modification of Diet in Renal Disease (MDRD) formula. Recently, a prospective population-based cohort study reported that 73.3% subjects had eGFR <75 mL/min/1.73 m 2 , on the basis of the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI).…”

Fatores associados à lesão renal aguda em pacientes cirúrgicos na unidade de terapia intensiva

“…Cardiovascular risk factors and associated comorbidities were: diabetes mellitus, arterial hypertension, dyslipidemia, obesity, thromboembolic diseases, sepsis, chronic obstructive pulmonary disease, stroke, rhabdomyolysis, congestive heart failure, myocardiopathy (ischemic and/or dilated), cardiac arrhythmia (atrioventricular block, fibrillation and/or arrhythmia), hypovolemia (hemorrhage and/or dehydration) and cardiorespiratory arrest event. Use of furosemide, non-steroidal or hormonal anti-inflammatory drugs, angiotensinogen-converting enzyme inhibitors, chemotherapeutic agents, antibiotics and vasoactive drugs were included as nephrotoxic drugs (5)(6)(7)(8) . Simultaneous antibiotic corresponded to the concomitant use of two or more drugs.…”