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Klöckl, MC; Kasparek, AK; Riedl, JM; Moik, F; Mollnar, S; Stotz, M; Szkandera, J; Terbuch, A; Gerger, A; Niedrist, T; Pichler, M; Bauernhofer, T; Schilcher, G; Zitta, S; Rosenkranz, AR; Friedl, C; Stöger, H; Posch, F.
Estimation versus measurement of the glomerular filtration rate for kidney function assessment in patients with cancer undergoing cisplatin-based chemotherapy.
Sci Rep. 2020; 10(1):11219
Doi: 10.1038/s41598-020-68010-5
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- Führende Autor*innen der Med Uni Graz
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Posch Florian
- Co-Autor*innen der Med Uni Graz
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Bauernhofer Thomas
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Gerger Armin
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Kasparek Anne-Katrin
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Moik Florian
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Niedrist Tobias
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Pichler Martin
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Riedl Jakob
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Rosenkranz Alexander
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Schilcher Gernot
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Stöger Herbert
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Stotz Michael
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Szkandera Joanna
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Terbuch Angelika
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Zitta Sabine
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- Abstract:
- 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 < 50 ml/min/1.73m2 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.
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Acute Kidney Injury - blood, chemically induced, diagnosis, urine
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Adult - administration & dosage
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Cisplatin - adverse effects
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Creatinine - blood, metabolism, urine
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Female - administration & dosage
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Glomerular Filtration Rate - drug effects, physiology
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Humans - administration & dosage
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Kidney - drug effects, physiopathology
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Male - administration & dosage
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Middle Aged - administration & dosage
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Neoplasms - blood, drug therapy, urine
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Renal Elimination - physiology
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Retrospective Studies - administration & dosage