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Renal function evaluation in patients with cancer who were scheduled to receive carboplatin or S-1

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Abstract

Background

Accurate glomerular filtration rate (GFR) evaluation is significant for drug dosing of carboplatin, anticancer drug excreted mainly from kidney. Serum cystatin-C (sCys-C) is a GFR marker with little affected by body muscle mass volume. And GFR equations based on serum creatinine (eGFRcreat) and sCys-C (eGFRcys) were developed; however, accuracy of eGFRcys has not been elucidated fully among patients with cancer. Therefore, we analyzed the performance of GFR equations among patients with cancer whose GFR values were measured by inulin clearance (Cin).

Methods

Study design was a cross-sectional study. Subjects were 41 patients with cancer whose GFR values were measured by Cin for drug dosing studies of carboplatin or S-1 in Nagoya University Hospital from 2007 to 2010 and 29 non-cancer patients. Correlation with Cin and slope of regression line were evaluated in eGFRcreat and eGFRcys. Single and multiple regression analyses were analyzed to identify associating factors with eGFRcreat/Cin or eGFRcys/Cin.

Results

Age, body weight, body mass index (BMI) and sCr were different between cancer patients and non-cancer patients, but sCys-C and Cin were consistent in 2 groups. The slope of the regression line for Cin vs. eGFRcys with zero intercept in cancer patients was 1.10 (95 % CI: 1.02–1.17), which was significantly different from 1.0. In multiple regression analysis revealed that BMI and urinary creatinine excretion were significantly associated with eGFRcreat/Cin, and cancer was only associating factor with eGFRcys/Cin.

Conclusion

eGFRcys should not be used for evaluation of renal function in patients with cancer because it underestimates GFR.

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Acknowledgments

This study was supported in part by JSPS KAKENHI, Research Grant form Aichi Jinzou Zaidan and Research Grant-in-Aid for Intractable Renal Diseases Research, Research on rare and intractable diseases, Health and Labour Sciences Research Grants from the Ministry of Health, Labour and Welfare of Japan.

Conflict of interest

AY received speaker honoraria from TAIHO Phamaceutical Co., Ltd., Japan.

Author information

Authors and Affiliations

  1. Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Kanako Shibata & Yoshinari Yasuda

  2. Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan

    Kanako Shibata, Teruo Tsuchiya & Hitomi Teramachi

  3. Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yoshinari Yasuda, Shoichi Maruyama & Seiichi Matsuo

  4. Department of Pharmacy, Gifu University Hospital, Gifu, Japan

    Ryo Kobayashi

  5. Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan

    Yuichi Ando & Tomoya Shimokata

  6. Division of Diabetes, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan

    Hideki Kamiya

  7. Department of Cardiology, Fujita Health University Second Hospital, Nagoya, Japan

    Mutsuharu Hayashi

  8. College of Pharmacy, Kinjo Gakuin University, Nagoya, Japan

    Makoto Nakao

Authors
  1. Kanako Shibata
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  2. Yoshinari Yasuda
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  3. Ryo Kobayashi
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  4. Yuichi Ando
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  5. Tomoya Shimokata
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  6. Hideki Kamiya
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  7. Mutsuharu Hayashi
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  8. Shoichi Maruyama
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  9. Seiichi Matsuo
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  10. Makoto Nakao
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  11. Teruo Tsuchiya
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  12. Hitomi Teramachi
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Corresponding author

Correspondence to Yoshinari Yasuda.

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Shibata, K., Yasuda, Y., Kobayashi, R. et al. Renal function evaluation in patients with cancer who were scheduled to receive carboplatin or S-1. Clin Exp Nephrol 19, 1107–1113 (2015). https://doi.org/10.1007/s10157-015-1115-1

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  • DOI: https://doi.org/10.1007/s10157-015-1115-1

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