Assessment of Glomerular Filtration Rate in Patients with Cancer: A Statement from the American Society of Onco-Nephrology

被引：13

作者：

Kitchlu, Abhijat ^{[1
,24
,25
]}

Silva, Veronica T. ^{[2
,3
]}

Anand, Shuchi ^{[4
]}

Kala, Jaya ^{[5
]}

Abudayyeh, Ala ^{[6
]}

Inker, Lesley A. ^{[7
]}

Rosner, Mitchell H. ^{[8
]}

Karam, Sabine ^{[9
]}

Gudsoorkar, Prakash ^{[10
]}

Gupta, Shruti ^{[11
,12
,13
]}

Chen, Sheldon ^{[6
]}

Klomjit, Nattawat ^{[9
]}

Leung, Nelson ^{[14
]}

Milanez, Tomaz ^{[15
]}

Motwani, Shveta S. ^{[16
]}

Khalid, Sheikh B. ^{[11
,12
,13
]}

Srinivasan, Vinay ^{[17
,18
]}

Wanchoo, Rimda ^{[19
]}

Beumer, Jan H. ^{[20
]}

Liu, Geoffrey ^{[21
]}

Tannir, Nizar M. ^{[22
]}

Orchanian-Cheff, Ani ^{[23
]}

Geng, Yimin ^{[6
]}

Herrmann, Sandra M. ^{[14
]}

机构：

[1] Univ Toronto, Univ Hlth Network, Dept Med, Div Nephrol, Toronto, ON, Canada

[2] Univ Sao Paulo, Fac Med, Serv Nefrol, Inst Canc Estado Sao Paulo, Sao Paulo, Brazil

[3] Univ Sao Paulo, Fac Med, Lab Invest Med LIM 16, Sao Paulo, SP, Brazil

[4] Stanford Univ, Dept Med Nephrol, Stanford, CA USA

[5] Univ Texas Hlth Sci Ctr Houston, McGovern Med Sch, Div Renal Dis & Hypertens, Houston, TX USA

[6] Univ Texas MD Anderson Canc Ctr, Sect Nephrol, Houston, TX USA

[7] Tufts Med Ctr, Div Nephrol, Boston, MA USA

[8] Univ Virginia Hlth, Div Nephrol, Charlottesville, VA USA

[9] Univ Minnesota, Div Nephrol & Hypertens, Minneapolis, MN USA

[10] Univ Cincinnati, Div Nephrol, Kidney CARE Program, Cincinnati, OH USA

[11] Brigham & Womens Hosp, Div Renal Med, Boston, MA USA

[12] Harvard Med Sch, Dept Med, Boston, MA USA

[13] Dana Farber Canc Inst, Dept Med Oncol, Boston, MA USA

[14] Mayo Clin, Div Nephrol & Hypertens, Rochester, MN USA

[15] Inst Oncol Ljubljana, Ljubljana, Slovenia

[16] Lahey Hosp & Med Ctr, Burlington, MA USA

[17] Cooper Univ Hosp, Div Nephrol, Camden, NJ USA

[18] Rowan Univ, Cooper Med Sch, Camden, NJ USA

[19] Northwell Hlth, Donald & Barbara Zucker Sch Med Hofstra Northwell, Glomerular Ctr Northwell Hlth, Div Kidney Dis & Hypertens, Great Neck, NY 11021 USA

[20] UPMC, Hillman Canc Ctr, Canc Therapeut Program, Pittsburgh, PA USA

[21] Univ Toronto, Princess Margaret Canc Ctr, Univ Hlth Network, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada

[22] Univ Texas MD Anderson Canc Ctr, Dept Genitourinary Med Oncol, Div Canc Med, Houston, TX USA

[23] Univ Hlth Network, Lib & Informat Serv, Toronto, ON, Canada

[24] Univ Hlth Network, Toronto, ON M5G 2C4, Canada

[25] Univ Toronto, Med, 200 Elizabeth St,8N-842, Toronto, ON M5G 2C4, Canada

来源：

CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2024年 / 19卷 / 08期

关键词：

CHRONIC KIDNEY-DISEASE; CYSTATIN-C; RENAL-FUNCTION; SERUM CREATININE; PLASMA-CLEARANCE; NEW-MODEL; CARBOPLATIN; GFR; PREDICTION; EQUATIONS;

D O I：

10.2215/CJN.0000000000000508

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Accurate assessment of glomerular filtration rate (GFR) is crucial to guiding drug eligibility, dosing of systemic therapy, and minimizing the risks of both undertreatment and toxicity in patients with cancer. Up to 32% of cancer patients have baseline chronic kidney disease (CKD), and both malignancy and treatment may cause kidney injury and subsequent CKD. To date, there has been lack of guidance to standardize approaches to GFR estimation in the cancer population. In this two-part statement from the American Society of Onco-Nephrology, we present key messages for estimation of GFR in patients with cancer, including the choice of GFR estimating equation, use of race and body surface-area (BSA)-adjustment, and anticancer drug dose-adjustment in the setting of CKD. These key messages are based on a systematic review of studies assessing GFR estimating equations using serum creatinine and cystatin C in patients with cancer, against a measured GFR comparator. The preponderance of current data involving validated GFR estimating equations involves the CKD-EPI equations, with 2,508 patients in whom CKD-EPI using serum creatinine and cystatin C was assessed (8 studies) and 15,349 in whom CKD-EPI with serum creatinine was assessed (22 studies). The former may have improved performance metrics and be less susceptible to shortfalls of eGFR using serum creatinine alone. Since included studies were moderate quality or lower, the ASON Position Committee rated the certainty of evidence as low. Additional studies are needed to assess the accuracy of other validated eGFR equations in patients with cancer. Given the importance of accurate and timely eGFR assessment we advocate for the use of validated GFR estimating equations incorporating both serum creatinine and cystatin C in patients with cancer. Measurement of GFR via exogenous filtration markers should be considered in patients with cancer for whom eGFR results in borderline eligibility for therapies or clinical trials.

引用

页码：1061 / 1072

页数：12

共 60 条

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