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How to assess kidney function in oncology patients.
Kidney International ( IF 14.8 ) Pub Date : 2020-03-03 , DOI: 10.1016/j.kint.2019.12.023
Jolanta Malyszko 1 , Michael W Lee 2 , Giovambattista Capasso 3 , Pawel Kulicki 1 , Joanna Matuszkiewicz-Rowinska 1 , Pierre Ronco 4 , Paul Stevens 5 , Petra Tesarova 6 , Davide Viggiano 3 , Anna Capasso 2
Affiliation  

Assessment of kidney function in oncology patients is a fundamental factor in profiling the survival risk, determining the appropriate dose of chemotherapeutic drugs, and defining a patient eligibility for clinical trials with novel agents. Both overestimation and underestimation of kidney function may affect the treatment efficacy and outcomes. Overestimation may lead to overdosing or inappropriate agent selection and the corresponding toxicity, whereas underestimation may be responsible for underdosing or inappropriate agent exclusion and subsequent treatment failure. This is of utmost importance in patients with cancer. Evaluation of kidney function is not only limited to the estimation of glomerular filtration rate or creatinine clearance. An accurate assessment of kidney function is advisable to reduce variability in decision making and ultimately the therapeutic outcomes of toxicity and clinical benefit. Therefore, additional studies are needed to investigate the validity of currently used formulas estimating kidney function in this population as well as their applicability to traditional chemotherapy, novel targeted therapies, and immunotherapies. Because of rapid discovery and development of new cancer agents, a reliable and comprehensive manner to screen for potential nephrotoxicity is critically important. As kidney function not only is limited to glomerular filtration rate changes but also involves tubular and even vascular dysfunction, urinalysis and kidney imaging studies should also be considered before therapeutic decisions are taken. However, several questions remain regarding these new technologies such as kidney-on-a-chip systems for the assessment of kidney function and injury, particularly in oncology, and it has yet to be implemented in clinical practice.

中文翻译:

如何评估肿瘤患者的肾功能。

评估肿瘤患者的肾功能是评估生存风险,确定合适的化疗药物剂量以及确定患者是否有资格使用新型药物进行临床试验的基本因素。肾脏功能的高估和低估都可能影响治疗效果和结果。高估可能导致用药过量或药物选择不当以及相应的毒性,而低估可能导致用药不足或药物排除不当以及随后的治疗失败。这在癌症患者中至关重要。肾功能的评估不仅限于肾小球滤过率或肌酐清除率的估计。建议对肾功能进行准确评估,以减少决策过程中的变异性,并最终降低毒性和临床获益的治疗效果。因此,需要进行更多的研究来调查目前使用的估计该人群肾功能的配方的有效性,以及它们在传统化学疗法,新型靶向疗法和免疫疗法中的适用性。由于新的癌症药物的迅速发现和发展,筛选潜在肾毒性的可靠而全面的方法至关重要。由于肾脏功能不仅限于肾小球滤过率变化,而且还涉及肾小管甚至血管功能障碍,因此在做出治疗决定之前,还应考虑尿液分析和肾脏成像研究。然而,
更新日期:2020-03-03
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