Assessment of Kidney Function in Patients With Cancer

Abstract

Cancer patients are living longer. The sequelae of cancer treatment and the role of comorbid conditions present before the diagnosis, such as CKD, have been increasingly recognized. The interface between CKD and cancer is multifaceted. CKD is frequently observed in patients with cancer, and cancer treatment contributes to CKD development and progression. In addition, CKD has been recognized as an important risk factor for cancer development and reduced specific cancer survival. In this context, an accurate evaluation of the glomerular filtration rate (GFR) during oncologic treatment is pivotal and is used to define surgery strategies, program prophylactic management of contrasted examinations, make decisions on cisplatin eligibility, and adjust drug prescriptions, particularly chemotherapy agents. Although the most commonly used equations to estimate GFR based on serum creatinine levels in clinical practice (Cockcroft-Gault, Modification of Diet in Renal Disease Study, and CKD Epidemiology Collaboration equations) have not been validated in patients with cancer in large prospective studies, there is increasingly evidence supporting the use of CKD Epidemiology Collaboration equation to assess the GFR in patients with cancer, including for the use of chemotherapy prescriptions. Many patients with cancer may have changes in nutrition status and clearance measurements such as exogenous filtration markers might be extremely useful when clinical decisions differ depending on the GFR level. Future perspectives include the advent of new serum GFR biomarkers such as cystatin C, beta-trace protein, and beta-2 microglobulin as well as the GFR assessment by measuring total kidney parenchymal volume through image examinations.

CAV2 promotes the growth of renal cell carcinoma through the EGFR/PI3K/Akt pathway

“…RCC progression is usually accompanied with uncontrollable proliferation, distant metastasis and recurrence. 4 – 7 However, the exact molecular mechanism of RCC is still unclear and needs to be further investigated.…”

Agreement and Precision Analyses of Various Estimated Glomerular Filtration Rate Formulae in Cancer Patients

“…The re-expressed MDRD study equation with the Thai racial factor, a preferable equation for CKD in the Thai population 10 , showed widest bias in eGFRs < 60 mL/min with a tendency of overestimation ( Fig. 2 ) , possibly due to sarcopenia in patients with cancer 30 . Indeed, the participants in the present study had an 8.5% lower mean muscle mass compared to those of patients with HIV infection (22.5 ± 5.8 vs. 24.6 ± 5.6 kg, p < 0.001), another chronic illness population 31 .…”

Serious adverse events in African–American cancer patients with sickle cell trait and inherited haemoglobinopathies in a SEER-Medicare claims cohort

“…Our results support observational evidence from large-scale studies showing an association of SCT with conditions possibly predisposing to treatment complications in cancer, particularly renal dysfunction, a disorder linked to poor prognosis in cancer patients. 9 Cancer patients with SCT exhibiting established or subclinical kidney disease might be at increased risk for kidneyrelated complications when exposed to physiologic stressors of systemic chemotherapeutic agents and surgical anaesthesia. Another putative mechanism for an increased risk of AEs could be through alterations in erythrocyte shape and function resulting from hypoxia and other stressors, particularly in SCT.…”