Renal insufficiency and cancer treatments

Launay-Vacher, Vincent; Janus, Nicolas; Deray, Gilbert

doi:10.1136/esmoopen-2016-000091

Cited by 64 publications

(65 citation statements)

References 30 publications

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“…Estimation of renal function is important since renal insufficiency is directly associated with increased mortality after cancer [43]. To explore the effect of renal function on prognosis, we also analyzed the association of serum Cys-C, CRE and e-GFR with the prognosis of RCC patients, respectively.…”

Section: Discussionmentioning

confidence: 99%

Preoperative serum cystatin-C as a potential biomarker for prognosis of renal cell carcinoma

Guo

Xue

et al. 2017

PLoS ONE

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PurposeThe prognostic value of serum cystatin-C (Cys-C) in renal cell carcinoma (RCC) remains unknown. The purpose of this study is to explore the prognostic value of Cys-C for RCC patients.Patients and methodsThe levels of preoperative Cys-C, creatinine (CRE) and estimated glomerular filtration rate (e-GFR) were retrospectively collected in 325 RCC patients undergoing surgery. The cutoff values of Cys-C, CRE and e-GFR were determined by the standardized Cutoff Finder algorithm. The receiver operating characteristic (ROC) curve and pairwise comparison were performed to compare the three variables. Univariate and multivariate Cox regression analyses were performed to investigate the prognostic value of serum Cys-C in RCC.ResultsBased on the analysis of Cutoff Finder algorithm, ROC curve and pairwise comparison, the preoperative Cys-C was superior to CRE and e-GFR as a predictive factor in RCC. Multivariate Cox regression analyses showed that high preoperative Cys-C (>1.09 mg/L) was significantly associated with shorter overall survival (OS) in all RCC patients (hazard ratio [HR], 1.59; P = 0.012), patients at pT1-2 (P<0.001), pN0 (P<0.001) and pM0 stages (P<0.001). Moreover, Multivariate Cox regression analyses also showed that in the 306 patients without metastasis, high preoperative Cys-C was also associated with shorter disease-free survival (DFS) (HR, 3.50; P = 0.013).ConclusionsAn elevated preoperative Cys-C level was demonstrated to be related with worse survival in patients with RCC. Measuring preoperative serum Cys-C might be a simple way for finding poor prognostic patients and patients with elevated preoperative Cys-C level should be more closely followed up.

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Section: Discussionmentioning

confidence: 99%

Preoperative serum cystatin-C as a potential biomarker for prognosis of renal cell carcinoma

Guo

Xue

et al. 2017

PLoS ONE

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“…Thus, bevacizumab and gemcitabine may cause vascular lesions, while platinum salts, methotrexate, cetuximab and vincristine expose patients to tubulo-interstitial lesions (25). RF was reported to be associated with reduced overall survival and increased mortality in cancer patients (26). In our study, advanced age, male gender, HIV infection, severity of RF and low hemoglobin level (<8 g/dL) were the risk factors for death.…”

Section: Discussionmentioning

confidence: 47%

Renal failure in cancer patients: results from the national cancer registry of Abidjan, Côte d’Ivoire

Yao¹,

Toure²,

Coulibaly³

et al. 2017

J Nephropathol

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Background: Renal failure (RF) is a risk factor for morbidity and mortality in cancer patients. Objectives: To describe the profile of cancer patients with RF. Patients and Methods: This is a retrospective descriptive study of RF in patients enrolled in the national cancer registry of Abidjan, during the period from January 2012 to December 2015. The diagnosis of RF was confirmed based on a measured glomerular filtration rate (GFR) < 60 mL/min obtained using the Modification in Diet of Renal Disease (MDRD) formula. A comparison of patients with (n = 131) or without (n = 136) RF, followed by a logistic regression analysis, made it possible to identify the risk factors for RF. Results: The mean age was 54 ± 13.9 years in the group with RF versus 49 ± 14.8 years in the group without RF (P = 0.003). The etiologies of RF were urinary tract obstruction (41.2%), administration of platinum salts (19.8%) and water losses (12.2%). In multivariate analysis, age (P = 0.009), presence of hypertension (P = 0.02), uterine cancer (P = 0.0001) and prostate cancer (P = 0.014) were associated with the risk of RF in cancer patients. Factors such as male gender (P = 0.007), HIV infection (P = 0.021), GFR<15 mL/min (P = 0.002), and hemoglobin level <8 g/dL (P = 0.041) were associated with mortality in cancer patients with RF. Conclusions: Late diagnosis leads to renal complications with an increased risk of mortality.

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“…For instance, the use of serum creatinine as a measure of GFR in patients with cancer may be influenced by poor dietary intake of protein, muscle wasting, malnutrition, changes in hydration, and liver disease that are prevalent in these patients (1). As an example of this, Launay-Vacher and colleagues (9,10) found that an abnormal serum creatinine was seen in ,10% of patients with cancer, whereas an abnormal GFR was seen in a much higher percentage (approximately 50%). In fact, it may be the case that patients with cancer more often present with abnormal GFRs than normal levels of kidney function.…”

Section: Introductionmentioning

confidence: 99%

“…In fact, it may be the case that patients with cancer more often present with abnormal GFRs than normal levels of kidney function. For instance, only 38.6% of patients with breast cancer, 38.9% of patients with lung cancer, 38.3% of patients with prostate cancer, 27.5% of patients with gynecologic cancer, and 27.2% of patients with colorectal cancer had a GFR$90 ml/min per 1.73 m 2 at the time of therapy initiation (9,(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

GFR Measurement and Chemotherapy Dosing in Patients with Kidney Disease and Cancer

McMahon

Rosner

2020

Kidney360

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Chemotherapeutic agents require precise dosing to ensure optimal efficacy and minimize complications. For those agents that are removed from the body by the kidney, accurate knowledge of GFR is critical. In addition, GFR needs to be determined rapidly, easily, and, if possible, with little additional cost. The ability to easily measure GFR also allows for rapid detection of nephrotoxicity. Current methodologies include direct clearance measurement of an indicator substance or estimation of creatinine clearance or GFR through regression equations that use a serum marker, such as creatinine or cystatin C. These methodologies all have shortfalls and limitations, some of which are specific to the patient with cancer. Newer methodologies that directly measure GFR are in clinical trials and offer the ability to rapidly and noninvasively provide accurate estimates of drug clearance as well as detection of nephrotoxicity. These methods offer the opportunity to refine drug dosing and improve outcomes.

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Renal insufficiency and cancer treatments

Cited by 64 publications

References 30 publications

Preoperative serum cystatin-C as a potential biomarker for prognosis of renal cell carcinoma

Preoperative serum cystatin-C as a potential biomarker for prognosis of renal cell carcinoma

Renal failure in cancer patients: results from the national cancer registry of Abidjan, Côte d’Ivoire

GFR Measurement and Chemotherapy Dosing in Patients with Kidney Disease and Cancer

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