Dogan Ekrem, Izmirli Mustafa, Ceylan Kadir, Erkoc Reha, Sayarlioglu Hayriye, Begenik Huseyin, Alici Suleyman
Department of Internal Medicine, Yuzuncu Yil University, Van, Turkey.
Adv Ther. 2005 Jul-Aug;22(4):357-62. doi: 10.1007/BF02850082.
The frequency of chronic renal insufficiency among cancer patients is unclear. The aim of this study was to determine the frequency of impaired renal function within a population of cancer patients. One thousand two hundred seventeen patients (563 women, 654 men) with cancer underwent serum creatinine concentration and glomerular filtration rate (GFR) evaluations. The Cockcroft-Gault formula was used to estimate the GFR from the creatinine clearance (Cl(cr)). Renal insufficiency was defined as a GFR <or=90 mL/min. Among this population, 72 (5.9%) demonstrated an abnormal serum creatinine concentration (>1.2 mg/dL). According to the Cockcroft-Gault formula evaluations, however, 330 (27.1%) of the patients had an estimated GFR <90 mL/min. Among these, the Clcr was between 60 and 89 mL/min in 241 patients (19.8%); 30 and 59 mL/min in 75 patients (6.2%); and 15 and 29 mL/min in 7 patients (0.6%); 7 patients (6%) had a Cl(cr) <15 mL/min. As a result, 21.2% of patients demonstrating a normal serum creatinine level had abnormal renal function. Renal function should be evaluated in all cancer patients, regardless of their serum creatinine level, before any drug regimen is administered. The Cockcroft-Gault formula appears to be more accurate than serum creatinine concentration for diagnosing renal insufficiency in patients with cancer, but more prospective studies in this population will be necessary to confirm this finding.
癌症患者中慢性肾功能不全的发生率尚不清楚。本研究的目的是确定癌症患者群体中肾功能受损的发生率。1217例癌症患者（563例女性，654例男性）接受了血清肌酐浓度和肾小球滤过率（GFR）评估。采用Cockcroft-Gault公式根据肌酐清除率（Cl(cr)）估算GFR。肾功能不全定义为GFR≤90 mL/分钟。在该群体中，72例（5.9%）血清肌酐浓度异常（>1.2 mg/dL）。然而，根据Cockcroft-Gault公式评估，330例（27.1%）患者的估算GFR<90 mL/分钟。其中，241例患者（19.8%）的Clcr在60至89 mL/分钟之间；75例患者（6.2%）的Clcr在30至59 mL/分钟之间；7例患者（0.6%）的Clcr在15至29 mL/分钟之间；7例患者（6%）的Cl(cr)<15 mL/分钟。结果，血清肌酐水平正常的患者中有21.2%肾功能异常。在给予任何药物治疗方案之前，所有癌症患者均应评估肾功能，无论其血清肌酐水平如何。对于诊断癌症患者的肾功能不全，Cockcroft-Gault公式似乎比血清肌酐浓度更准确，但需要在该群体中进行更多前瞻性研究来证实这一发现。
