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Comparison of different estimated glomerular filtration rates for monitoring of kidney function in oncology patients.
Vermassen, Tijl; Geboes, Karen; Lumen, Nicolaas; Van Praet, Charles; Rottey, Sylvie; Delanghe, Joris.
Afiliación
  • Vermassen T; Department of Medical Oncology, University Hospital Ghent, Ghent, Belgium.
  • Geboes K; Biomarkers in Cancer, Ghent University, Ghent, Belgium.
  • Lumen N; Cancer Research Institute Ghent, Ghent, Belgium.
  • Van Praet C; Cancer Research Institute Ghent, Ghent, Belgium.
  • Rottey S; Digestive Oncology, Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium.
  • Delanghe J; Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.
Clin Kidney J ; 17(1): sfae006, 2024 Jan.
Article en En | MEDLINE | ID: mdl-38288036
ABSTRACT

Background:

Tyrosine kinase inhibitors (TKIs) are associated with kidney function deterioration. A shift is ongoing towards glomerular filtration rate (GFR) equations based on other protein markers, such as cystatin C (CSTC) and ß-trace protein (BTP). We evaluated various GFR equations for monitoring of kidney function in actively treated oncology patients.

Methods:

We monitored 110 patients receiving a TKI. Blood and urine were collected during therapy. Serum analysis included creatinine (Cr), CSTC and BTP; for consequent GFR determination. Urine was analysed for protein, albumin, immunoglobulin G, and α-1-microglobulin. A similar analysis was done in a patient subgroup receiving immune checkpoint inhibitors (ICI) as prior or subsequent line of therapy.

Results:

Cr remained constant during TKI treatment (P = 0.7753), whereas a significant decrease in CSTC (from week 2 onward, P < 0.0001) and BTP (at weeks 2 and 4, P = 0.0100) were noticed. Consequently, GFR estimations, using CSTC and/or BTP as a biochemical parameter, showed an apparent increase in GFR, whereas this was not observed for Cr-related GFR estimations. As a result, the GFR gap (ΔGFR) was significantly different from week 2 onward between Cr-based and CSTC-based GFR and between BTP-based and CSTC-based GFR. Glomerular damage was noticed with significant increase in urine protein-to-creatinine ratio, albumin-to-creatinine ratio and immunoglobulin G (all P < 0.0001). No change in α-1-microglobulin was seen. ICI treatment had no effect on Cr (P = 0.2262), CSTC (P = 0.7341), and BTP concentrations (P = 0.3592).

Conclusion:

GFR equations, in which CSTC is incorporated, fail to correctly estimate the GFR in oncology patients treated with TKIs. As TKI-treated patients show clear signs of glomerular injury, further assessment is needed on how to correctly monitor the kidney function in actively treated oncology patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Kidney J Año: 2024 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Kidney J Año: 2024 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Reino Unido