Estimation versus measurement of the glomerular filtration rate for kidney function assessment in patients with cancer undergoing cisplatin-based chemotherapy
Autor: | Anne-Katrin Kasparek, Gernot Schilcher, S. Mollnar, Herbert Stöger, Jakob M. Riedl, Michael Stotz, Angelika Terbuch, Armin Gerger, Alexander R. Rosenkranz, Marie-Christin Klöckl, Sabine Zitta, Thomas Bauernhofer, Joanna Szkandera, Tobias Niedrist, Florian Posch, Florian Moik, Martin Pichler, Claudia Friedl |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty Urinary system 030232 urology & nephrology Urology Renal function lcsh:Medicine Kidney Article 03 medical and health sciences 0302 clinical medicine Neoplasms medicine Clinical endpoint Humans Chemotherapy In patient ddc:610 lcsh:Science Retrospective Studies Cisplatin Multidisciplinary business.industry Genitourinary system lcsh:R Cancer Retrospective cohort study Acute Kidney Injury Middle Aged medicine.disease Renal Elimination 030220 oncology & carcinogenesis Creatinine Female lcsh:Q business medicine.drug Glomerular Filtration Rate |
Zdroj: | Scientific Reports, Vol 10, Iss 1, Pp 1-10 (2020) Scientific Reports |
ISSN: | 2045-2322 |
Popis: | Glomerular filtration rate (GFR) assessment is indicated before every administration of cisplatin. The optimal modality for this purpose [GFR measurement by urinary Creatinine Clearance (uCrCl) versus GFR estimation (eGFR) by the CKD-EPI formula versus both] is unclear. We investigated whether eGFR only is safe in this setting. Paired uCrCl and eGFR determinations from 470 cisplatin cycles from 121 patients were analyzed [median age: 55 years; most frequent tumor site: genitourinary (45%); palliative treatment: n = 41 (34%)]. Primary endpoint was the proportion of cycles with uCrCl 2 and eGFR ≥ 50 ml/min/1.73m2 (i.e. a “false negative” result when only determining eGFR). The primary endpoint occurred in 8 of 470 cisplatin cycles (1.7%, 95%CI 0.5–2.9). In all 8 events, uCrCl was lower than eGFR (mean uCrCl vs. eGFR: 43 versus 112 ml/min/1.73m2). The uCrCl was re-measured in all patients, and showed normal results in all but 1 patient. None of these events precluded the administration of cisplatin at the planned date, and no subsequent cases of acute nephrotoxicity occurred. Overall agreement between uCrCl and eGFR was low, with qualitative analysis suggesting frequent incompliance with 24-h urine collection. We conclude that an eGFR is sufficient for assessing kidney function in patients with cancer undergoing cisplatin therapy. |
Databáze: | OpenAIRE |
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