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Prevalence of Renal Insufficiency in cancer patients and implications for anticancer drug management
The renal insufficiency and anticancer medications (IRMA) study
Article first published online: 17 JUL 2007
Copyright © 2007 American Cancer Society
Volume 110, Issue 6, pages 1376–1384, 15 September 2007
How to Cite
Launay-Vacher, V., Oudard, S., Janus, N., Gligorov, J., Pourrat, X., Rixe, O., Morere, J.-F., Beuzeboc, P., Deray, G. and On behalf of the Renal Insufficiency and Cancer Medications (IRMA) Study Group (2007), Prevalence of Renal Insufficiency in cancer patients and implications for anticancer drug management. Cancer, 110: 1376–1384. doi: 10.1002/cncr.22904
- Issue published online: 31 AUG 2007
- Article first published online: 17 JUL 2007
- Manuscript Accepted: 7 MAY 2007
- Manuscript Revised: 28 APR 2007
- Manuscript Received: 27 MAR 2007
- abbreviated Modification of Diet in Renal Disease formula;
- Cockcroft-Gault formula;
- creatinine clearance;
- renal insufficiency;
- serum creatinine;
- solid tumors
The Renal Insufficiency and Cancer Medications (IRMA) study is a French national observational study. The results from this study of nearly 5000 patients demonstrated the high prevalence of renal impairment in a population of patients with solid tumors.
Every cancer patient who presented at oncology departments that participated in the study over at least 1 of 2 predefined periods during 2004 were included. Renal function was calculated using Cockcroft-Gault and abbreviated Modification of Diet in Renal Disease (aMDRD) formulae to estimate the prevalence of renal insufficiency (RI) according to the Kidney Disease Outcomes Quality Initiative-Kidney Disease Improving Global Outcomes definition and stratification. Anticancer drugs were studied with regard to their potential renal toxicity and dosage adjustment.
Of the 4684 patients from the 15 centers, 7.2% had serum creatinine levels >110 μmol/L. However, when they were assessed using Cockcroft-Gault and aMDRD formulae, 57.4% and 52.9% of patients had abnormal renal function or RI, respectively. Of the 7181 anticancer drug prescriptions, 53.4% required dose adjustments for RI. Of the patients treated, 79.9% received at least 1 such drug. And 80.1% received potentially nephrotoxic drugs.
RI was common in patients with cancer, and drug dosage adjustments often were necessary. Renal function should be evaluated in all cancer patients using either the Cockcroft-Gault formula or the aMDRD formula, including patients with normal serum creatinine levels. In patients who are at high risk for drug toxicity, the dosage should be adapted to renal function, and the use of nephrotoxic therapies should be avoided whenever possible. Cancer 2007. © 2007 American Cancer Society.