Urological Research Institute (URI), Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Unit of Urology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Kidney Blood Press Res. 2024;49(1):336-344. doi: 10.1159/000538854. Epub 2024 Apr 18.
In the era of precision medicine, determining reliable renal function assessment remains a critical and debatable issue, especially in nephrology and oncology.
This paper delves into the significance of accurately measured glomerular filtration rate (mGFR) in clinical practice, highlighting its essential role in guiding medical decisions and managing kidney health, particularly in the context of renal cancer (RC) patients undergoing nephrotoxic anti-cancer drugs. The limitations and advantages of traditional glomerular filtration rate (GFR) estimation methods, primarily using serum biomarkers like creatinine and cystatin C, are discussed, emphasizing their possible inadequacy in cancer patients. Specifically, newer formulae designed for GFR estimation in cancer patients may not perform at best in RC patients. The paper explores various methods for direct GFR measurement, including the gold standard inulin clearance and alternatives like iohexol plasma clearance.
Despite the logistical challenges of these methods, their implementation is crucial for accurate renal function assessment. The paper concludes by emphasizing the need for continued research and innovation in GFR measurement methodologies to improve patient outcomes, particularly in populations with complex medical needs.
在精准医学时代，确定可靠的肾功能评估仍然是一个关键且有争议的问题，特别是在肾病学和肿瘤学领域。
本文深入探讨了准确测量肾小球滤过率（mGFR）在临床实践中的意义，强调了其在指导医疗决策和管理肾脏健康方面的重要作用，特别是在接受肾毒性抗癌药物治疗的肾癌（RC）患者中。本文讨论了传统肾小球滤过率（GFR）估计方法的局限性和优势，这些方法主要使用血清生物标志物如肌酐和胱抑素 C，强调了它们在癌症患者中的可能不适用性。具体而言，专为癌症患者设计的新型 GFR 估计公式在 RC 患者中可能无法达到最佳效果。本文探讨了直接 GFR 测量的各种方法，包括金标准菊粉清除率和碘海醇血浆清除率等替代方法。
尽管这些方法存在操作上的挑战，但为了准确评估肾功能，实施这些方法至关重要。本文最后强调需要继续研究和创新 GFR 测量方法，以改善患者的治疗效果，特别是在具有复杂医疗需求的人群中。
