Incidence of renal insufficiency in cancer patients

2005 ◽  
Vol 22 (4) ◽  
pp. 357-362 ◽  
Author(s):  
Ekrem Dogan ◽  
Mustafa Izmirli ◽  
Kadir Ceylan ◽  
Reha Erkoc ◽  
Hayriye Sayarlioglu ◽  
...  
Keyword(s):  
Renal Insufficiency ◽  
Cancer Patients

Renal insufficiency in bone metastasis cancer patients: Prevalence and implications on anticancer drugs management, subgroup analysis of the IRMA study

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9121-9121 ◽  
Author(s):  
N. Janus ◽  
C. Le Tourneau ◽  
V. Launay-Vacher ◽  
J. Gligorov ◽  
O. Rixe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Metastasis ◽  
Renal Insufficiency ◽  
Cancer Patients ◽  
Anticancer Drugs ◽  
Subgroup Analysis ◽  
Dosage Adjustment ◽  
Breast Cancer Patients ◽  
Chi Square ◽  
Chi Square Test

9121 Background: The IRMA study reported the high prevalence of renal insufficiency (RI) in 4684 solid tumour patients, with a glomerular filtration rate (GFR) <90 ml/min for 50–60%. Furthermore, 80.1% were receiving nephrotoxic anticancer drugs and 79.9% drugs necessitating dosage adjustment. We present the results for IRMA patients with bone metastasis (BM). Methods: Subgroup analysis of IRMA patients with BM. Data collected: sex, age, weight, serum creatinine (SCR), bone metastasis (BM) and anticancer drugs. The prevalence of SCR>110 μmol/L was assessed. GFR was estimated with Cockcroft-Gault (CG) and abbreviated MDRD (aMDRD) formulae. Drugs necessitating dosage adjustment and those potentially nephrotoxic were identified. Chi-square test was used to compare the prevalence of RI between patients with BM and patients without, for all patients and for breast cancer (BC) ones. Results: 1,000 patients (BC 577) with BM were included: median age 60, mean 59.8, weight 66 kg, 659 women. The prevalence of SCR>110 μmol/L was 8.3%. That of GFR<90 ml/min was 57.9% with CG and 54.7% with aMDRD. 83.4% of treated patients received at least one drug needing dosage adjustment (or no data) and 69% received at least one nephrotoxic drug. The prevalence of RI was not statistically different between patients with or without BM. However, the prevalence of RI was significantly higher in BC patients with BM as compared to BC patients without BM (62.1 versus 56.7 %, p=0.04). Conclusions: RI is highly frequent in cancer patients with BM. Appropriate evaluation of renal function necessitates CG or aMDRD calculation. In those patients, and especially in breast cancer patients with BM, anticancer drugs should be cautiously selected regarding their potential renal toxicity and need for dosage adjustment. [Table: see text] No significant financial relationships to disclose.

Prevalence of renal insufficiency in cancer patients: Data from the IRMA-2 study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9559-9559 ◽  
Author(s):  
N. Janus ◽  
S. Oudard ◽  
P. Beuzeboc ◽  
J. Gligorov ◽  
I. Ray-Coquard ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Insufficiency ◽  
Cancer Patients ◽  
Anticancer Drugs ◽  
Dosage Adjustment ◽  
Phase 1 ◽  
Time Data ◽  
Cross Sectional ◽  
Co Morbidity ◽  
High Prevalence

9559 Background: The IRMA-1 study reported the high prevalence of renal insufficiency (RI) in 4,684 cancer patients, with a glomerular filtration rate (GFR) <90 and <60 ml/min/1.73m2 for 52.9% and 12.0%, respectively. Furthermore, almost 80% of patients were receiving nephrotoxic drugs or drugs necessitating dosage adjustment. The IRMA-2 study was started one year later, in different patients, and consisted of 2 phases: 1) a cross-sectional study, similar to IRMA-1, and 2) a 2-year retrospective follow-up of the patients to describe the evolution of their renal function along with time. Data from the phase 1 were compared to the results of IRMA-1 in terms of RI prevalence. Methods: Data were collected for cancer patients presenting at one of the 19 IRMA-2 centers in March 2005: type of tumour, sex, age, weight, serum creatinine (SCR), and anticancer drugs. Dialysis, myeloma and lymphoma patients were not included. The prevalence of SCR>110 μmol/L was assessed. GFR was estimated with the aMDRD formula, anticancer drugs necessitating dosage adjustment and those potentially nephrotoxic were identified. Results: 4,945 patients (breast 1816, colorectal 747, lung 463, ovarian 294, prostate 251) were included in the IRMA-2 study. Median age 60.0, mean weight 66.2, 62.8% were women. The prevalence of an elevated SCR (SCR>110μmol/l) was 7.2% (vs. 7.2% in IRMA-1), that of a GFR < 90 ml/min/1.73m2 was 50.2% (vs. 52.9%) and that of a GFR < 60 ml/min/1.73m2 was 11.9% (vs. 12.0%) ( Table ). 73.2% of treated patients (n=3882) were receiving at least one drug needing dosage adjustment and 75.5% received at least one nephrotoxic drug (vs. 79.9 and 80.1%, respectively). Conclusions: The results of IRMA-2 and IRMA-1 confirm the high prevalence of RI in cancer patients, on 2 different cohorts of nearly 5,000 cancer patients each. This underlines that estimating renal function in cancer patients is mandatory and that this highly frequent co-morbidity should be considered. [Table: see text] No significant financial relationships to disclose.

Risk of acute renal failure among breast cancer patients and chemotherapy treatment of breast cancer patients with a history of renal insufficiency in a commercially-insured population in the United States

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22104-e22104 ◽  
Author(s):  
W. J. Langeberg ◽  
C. D. O'Malley ◽  
C. W. Critchlow ◽  
J. P. Fryzek
Keyword(s):  
Breast Cancer ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Renal Insufficiency ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
The United States ◽  
First Year ◽  
Breast Cancer Patients ◽  
History Of

e22104 Background: Risk of acute renal failure (ARF) among breast cancer (BC) patients may increase with nephrotoxic chemotherapy and other exposures, but this risk is not well characterized. Furthermore, among patients who present with renal insufficiencies (RI) at cancer diagnosis, subsequent treatment patterns are not well described. Methods: We performed a retrospective cohort study using a large national commercial claims database. The cohort included all women diagnosed with BC from 2000 to 2007 who were 18–64 years at diagnosis with no history of cancer (n=13,296). We defined a diagnosis of BC as at least one inpatient or two outpatient claims more than 30 days apart with an ICD-9 code of 174. Among patients with no history of RI (n=13,150), we calculated the cumulative incidence (CI) of ARF_the proportion with at least one inpatient or two outpatient claims with an ICD-9 code of 584 or 586 in the first year following cancer diagnosis. Treatment for BC patients with a history of RI (n=146) was also assessed. Results: Among BC patients with no history of RI, 0.3% were diagnosed with ARF within a year after cancer diagnosis. The CI of ARF was higher in patients with metastases: 0.7% for any metastasis, 2.3% for bone metastasis, and 0.1% for no metastasis. The CI of ARF among patients undergoing radiation or mastectomy was similar to the overall rate (0.3%) but was higher in patients receiving nephrotoxic chemotherapy (1.0%) or intravenous bisphosphonates (IV BPs) (2.1%). The CI of ARF was higher in patients with congestive heart failure (1.4%), diabetes (0.9%), and/or hypertension (0.8%) at cancer diagnosis compared to patients without these comorbidities (0.2%). Among BC patients with a history of RI, 7.5% were administered nephrotoxic chemotherapy, 30.1% received potentially nephrotoxic chemotherapy, and 1.4% were given IV BPs. Conclusions: Breast cancer patients who present with comorbidities, develop metastases, or are given nephrotoxic chemotherapy or IV bisphosphonates are at higher risk of acute renal failure in the first year after breast cancer diagnosis. More research is warranted on the treatment of breast cancer patients with a history of renal insufficiency. [Table: see text]

Renal insufficiency and anticancer drugs in elderly cancer patients: A subgroup analysis of the IRMA study

2009 ◽  
Vol 70 (2) ◽  
pp. 124-133 ◽  
Author(s):  
Vincent Launay-Vacher ◽  
Jean-Philippe Spano ◽  
Nicolas Janus ◽  
Joseph Gligorov ◽  
Isabelle Ray-Coquard ◽  
...  
Keyword(s):  
Renal Insufficiency ◽  
Cancer Patients ◽  
Anticancer Drugs ◽  
Subgroup Analysis ◽  
Elderly Cancer Patients

scholarly journals Canadian consensus recommendations on the management of venous thromboembolism in patients with cancer. Part 2: treatment

2015 ◽  
Vol 22 (2) ◽  
pp. 144 ◽  
Author(s):  
J.C. Easaw ◽  
M.A. Shea-Budgell ◽  
C.M.J. Wu ◽  
P.M. Czaykowski ◽  
J. Kassis ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Renal Insufficiency ◽  
Cancer Patients ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Anticoagulation Therapy ◽  
Factor Xa ◽  
Patients With Cancer ◽  
Clinical Scenarios ◽  
Increased Risk

Patients with cancer are at increased risk of venous thromboembolism (vte). Anticoagulation therapy is used to treat vte; however, patients with cancer have unique clinical circumstances that can often make decisions surrounding the administration of therapeutic anticoagulation complicated. No national Canadian guidelines on the management of established cancer-associated thrombosis have been published. We therefore aimed to develop a consensus-based, evidence-informed guideline on the topic.PubMed was searched for clinical trials and meta-analyses published between 2002 and 2013. Reference lists of key articles were hand-searched for additional publications. Content experts from across Canada were assembled to review the evidence and make recommendations.Low molecular weight heparin is the treatment of choice for cancer patients with established vte. Direct oral anticoagulants are not recommended for the treatment of vte at this time. Specific clinical scenarios, including the presence of an indwelling venous catheter, renal insufficiency, and thrombocytopenia, warrant modifications in the therapeutic administration of anticoagulation therapy. Patients with recurrent vte should receive extended (>3 months) anticoagulant therapy. Incidental vte should generally be treated in the same manner as symptomatic vte. There is no evidence to support the monitoring of anti–factor Xa levels in clinically stable cancer patients receiving prophylactic anticoagulation; however, levels of anti–factor Xa could be checked at baseline and periodically thereafter in patients with renal insufficiency. Follow-up and education about the signs and symptoms of vte are important components of ongoing patient care.

Renal function evolution in cancer patients. Results of the IRMA-2 study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20574-e20574
Author(s):  
S. Oudard ◽  
N. Janus ◽  
J. Gligorov ◽  
P. Beuzeboc ◽  
I. Ray ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Insufficiency ◽  
Cancer Patients ◽  
High Frequency ◽  
Tumour Metastasis ◽  
High Prevalence ◽  
Nephrotoxic Drugs ◽  
Mild Renal Insufficiency ◽  
Time Point

e20574 Background: In 2007, the IRMA-1 study reported the high prevalence of renal insufficiency (RI) in cancer patients. Because of this high frequency, the IRMA-2 study started to investigate the evolution of renal function in cancer patients. Methods: Data were collected for cancer patients presenting at one of the 19 IRMA-2 centers in March 2005. Data included: sex, age, weight, serum creatinine (SCR), haemoglobinemia, type of tumour, metastasis (bone and/or visceral) anticancer drugs. Dialysis, myeloma and lymphoma patients were not included. Glomerular filtration rate was estimated with the abbreviated RD (aRD) formula at the inclusion. Patients were retrospectively followed during 2 years after the inclusion, every 6 months, from March 2005 (T0) to March 2007 (T24). Results: 4945 cancer patients (breast 1816, colorectal 747, lung 463, ovarian 294, prostate 251) were included in 19 cancer centre in France. Median age 60.0, mean weight 66.2, 62.8% were women. Mean GFR decreased from 90.8 ml/min/1.73m2 to 83.7 over the two years (table). Meanwhile, the prevalence of RI increased, reaching 62.9% and 17.5% for a GFR<90 and <60, respectively at T24 (table). Among the 4945 patients, 193 (7.6% of the 2525 patients who were alive at the end of the study) had a SCR determination at each time point. Among the 641 patients with a SCR at T0 and at T24, 41.6% of those with a GFR>=90 at T0 had a GFR<90 at T24. Furthermore, 17.7% of patients with mild renal insufficiency (60 to 90) at T0 had a GFR<60 at T24. Conclusions: IRMA-2 shows that renal function decreases rapidly in cancer patients with a loss in GFR of more than 3.5 mL/min/1.73m2 per year. This suggests that cancer patients are more exposed to a deterioration of renal function and that it should be closely monitored with at least a regular estimation of renal function, for instance every 6 months. So far, such a follow-up is not performed in clinical practice. Furthermore, drug therapy should be reevaluated, dosages adjusted when necessary, and some potentially nephrotoxic drugs changed for less or non-nephrotoxic drugs if possible. No significant financial relationships to disclose.

Zoledronic Acid (ZA)- Associated Nephrotoxicity: An Analysis of Adverse Drug Reaction (ADR) Reports by the Research on Adverse Drug Events and Reports (RADAR) Project.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3139-3139
Author(s):  
June M. McKoy ◽  
Eniola Obadina ◽  
Paul R. Yarnold ◽  
Victoria Kut ◽  
Dennis W. Raisch ◽  
...  
Keyword(s):  
United States ◽  
Multiple Myeloma ◽  
Adverse Event ◽  
Zoledronic Acid ◽  
Renal Insufficiency ◽  
Serum Creatinine ◽  
Cancer Patients ◽  
Clinical Characteristics ◽  
The United States ◽  
Close Monitoring

Abstract Background-The FDA originally approved zoledronic acid (ZA) in August 2001 for the treatment of hypercalcemia of malignancy and subsequently for prevention of skeletal related events among patients with multiple myeloma (MM), breast, and prostate cancer. Since its approval, the FDA has received several reports of nephrotoxicity. Many of these individuals have myeloma, a malignancy associated with renal damage. Herein, RADAR investigators reviewed the clinical characteristics of ZA-induced nephrotoxicity among cancer patients with multiple myeloma versus other malignancies. We investigated the clinical characteristics and reporting quality of all adverse event (AE) reports describing ZA-associated neprotoxicity. Methods- We analyzed reports of ZA-associated nephrotoxicity from the FDA’s Adverse Event Reporting System, which included a total of 141 AE reports, with exclusion of cases/trials reported in duplicate. Results- Overall, 141 cases of ZA-associated renal failure (RF) were identified: 92 case reports were from the United States and 44 were from non-United States countries. Reporting completeness was generally poor, with respect to serum creatinine levels and frequency of ZA administration, especially in reports from Canada and Great Britain respectively. Two thirds of the patients with scheduling information had received ZA every 4 weeks. Infusion rate was reported for 21%, and was usually 15 minutes or longer. NSAIDS and Cox-II inhibitor exposures were reported in 25%, and 20% of the patients who had prior diagnoses of renal insufficiency. Patients with MM (n=82) had similar mean age as patients with other cancers (n= 54) (72.05 versus 72.9 years). For patients for whom data was available (n=62), pamidronate was used by 97.8% in the MM group versus 86.9% in the non-myeloma group. The onset of RF occurred after a mean of 67.9 days in the MM group (range, 3–366) versus 73.7 days in the non-myeloma group (range, 0–546 days) post initiation of ZA; after a mean number of ZA doses (2.5 vs. 1.8 doses). Only one dose of ZA was received by 24.4% and 25.4% of MM versus non-myeloma patients respectively, which occurred after an average of 14.7 days and 30 days. RF manifestations included serum Cr &gt; 2 for 59.7% of the MM and 83.1% of the other cancer patients. Outcomes of RF in MM and non-myeloma patients, respectively, included hospitalization (61% and 71%) and dialysis, (38% and 22%). Conclusions- Close monitoring of serum creatinine prior to ZA, is important for both MM and other cancer patients; completeness of current case reporting efforts of ZA-associated renal insufficiency is poor in both US and non-US countries; and information about the potential occurrence of renal toxicity should be prominently described in the packet insert for ZA.

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