Pathology and Legal Medicine, Medical School, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Clinical Dentistry Department, Dentistry School, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Support Care Cancer. 2022 Sep;30(9):7271-7280. doi: 10.1007/s00520-022-07159-3. Epub 2022 May 21.
Antineoplastic treatments, mainly chemotherapy, affect the kidneys, causing toxicity, and can trigger acute and chronic kidney injuries. This study aimed to analyze the prevalence of renal disorders in patients with oncohematological neoplasms receiving antineoplastic treatment.
This retrospective cohort study included 75 patients with hematological cancer who underwent chemotherapy between 2012 and 2018 in the Hematology Sector of the Walter Cantídeo University Hospital of the Federal University of Ceará. Sociodemographic and clinical data, blood biochemical assessment findings, and glomerular filtration rate (GFR) were analyzed using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. The data were tabulated; transferred to the Statistical Package for the Social Sciences software, version 20.0; and analyzed using Pearson's chi-square test or Fisher's exact test for categorical variables followed by a multinomial logistic regression model (p < 0.05).
The prevalence of renal disorders was 52.4% according to the CKD-EPI equation for GFR events. There was a significant association between the decrease in GFRs and the following variables: female sex (p = 0.002), diagnosis of multiple myeloma (p = 0.008), start of treatment within 40 days (p = 0.005), and the following antineoplastic treatments: cyclophosphamide, vincristine, and prednisone (p = 0.026); irarubicin (p = 0.032); azacytidine, dexamethasone, and cyclophosphamide (p < 0.001); zoledronic acid (p < 0.001); and pamidronate (p = 0.012). CALGB 8811 (p < 0.001) was inversely associated with a reduction in the GFR.
The prevalence of renal disorders was high in patients with oncohematological neoplasms receiving antineoplastic treatment. This requires periodic monitoring of the evaluation of renal function since reductions in GFRs were significantly associated with different treatment protocols used.
抗肿瘤治疗（主要是化疗）会影响肾脏，导致毒性，并可能引发急性和慢性肾损伤。本研究旨在分析接受抗肿瘤治疗的血液肿瘤患者中肾脏疾病的患病率。
本回顾性队列研究纳入了 2012 年至 2018 年期间在联邦大学沃尔特坎蒂迪奥大学医院血液科接受化疗的 75 例血液癌患者。采用慢性肾脏病流行病学协作（CKD-EPI）方程分析患者的社会人口统计学和临床数据、血液生化评估结果以及肾小球滤过率（GFR）。使用 Pearson 卡方检验或 Fisher 确切检验对分类变量进行制表，并将数据传输至统计软件包社会科学版 20.0 版，然后采用多变量逻辑回归模型进行分析（p<0.05）。
根据 GFR 事件的 CKD-EPI 方程，肾脏疾病的患病率为 52.4%。GFR 下降与以下变量显著相关：女性（p=0.002）、多发性骨髓瘤诊断（p=0.008）、治疗开始后 40 天内（p=0.005）以及以下抗肿瘤治疗：环磷酰胺、长春新碱和泼尼松（p=0.026）；伊达比星（p=0.032）；阿扎胞苷、地塞米松和环磷酰胺（p<0.001）；唑来膦酸（p<0.001）；和帕米膦酸（p=0.012）。CALGB 8811（p<0.001）与 GFR 降低呈负相关。
接受抗肿瘤治疗的血液肿瘤患者中肾脏疾病的患病率较高。这需要定期监测肾功能评估，因为 GFR 降低与使用的不同治疗方案显著相关。
