Incidence of renal insufficiency in cancer patients and evaluation of information available on the use of anticancer drugs in renally impaired patients

• Published in: Medical science monitor Vol. 10; no. 5; p. CR209
• Main Authors: Launay-Vacher, Vincent, Izzedine, Hassane, Rey, Jean-Baptiste, Rixe, Olivier, Chapalain, Sophie, Nourdine, Souraya, Paci, Angelo, Bourget, Philippe, Deray, Gilbert
• Format: Journal Article
• Language: English
• Published: United States 01.05.2004
• Subjects: Aged; Antineoplastic Agents - adverse effects; Antineoplastic Agents - pharmacology; Creatinine - blood; Female; Glomerular Filtration Rate; Humans; Incidence; Kidney - pathology; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - etiology; Kidney Function Tests; Male; Middle Aged; Neoplasms - complications; Neoplasms - drug therapy
• ISSN: 1234-1010

Chronic renal failure is a common pathology. The high frequency of this disease in the general US population has been assessed in the NHANES III study. However, the frequency of chronic renal insufficiency among cancer patients remains unclear. 316 cancer patients were in a one-month study, included regardless of their pathology, treatment (antineoplastic drugs used or programmed to be used, pretreated, or no treatment), or any other criteria. Among the patients, 287 (90.8%) had normal serum creatinine levels (<110 micromol/l), i.e. a frequency of 9.2% for renal insufficiency in our population. However, when renal function was estimated by calculating creatinine clearance using the Cockcroft and Gault formula, 33% of the patients had an estimated GFR of less than 80 ml/min. Among these, 28% had a creatinine clearance ranging form 80 to 50 ml/min and 5% had a creatinine clearance of less than 50 ml/min. Renal insufficiency is frequent in cancer patients since almost one third of the patients present renal insufficiency. Furthermore, among patients with normal serum creatinine levels, one patient out of five has asymptomatic renal insufficiency. Therefore, it is of major importance that renal function be assessed by calculation of creatinine clearance using the Cockcroft and Gault formula in every patient, even when serum creatinine is within the normal range.