Association between renal function and chemotherapy-related toxicity in older adults with cancer

作者：Peterson Lindsay L^*; Hurria Arti; Feng Tao; Mohile Supriya G; Owusu Cynthia; Klepin Heidi D; Gross Cary P; Lichtman Stuart M; Gajra Ajeet; Glezerman Ilya; Katheria Vani; Zavala Laura; Smith David D; Sun Can Lan; Tew William P

来源：Journal of Geriatric Oncology, 2017, 8(2): 96-101.

DOI：10.1016/j.jgo.2016.10.004

• Renal function
• Chemotherapy toxicity
• Older adults
• Creatinine clearance

Purpose: To evaluate the association between renal RF) and chemotherapy-related toxicity (CRT) in older adults with cancer and to compare the effect of different RF formulas and body weight measurements on this association.
Methods: This is a secondary analysis of data from a prospective multicenter study of patients age 65 who were starting a new chemotherapy regimen. RF was estimated with 4 formulas (modified Jelliffe [Jelliffe], Cockcroft-Gault [CG], Wright, and Modification of Diet in Renal Disease [MDRD]), using actual, ideal and adjusted body weights for 492 patients. The association between baseline RF and grade 3-5 CRT was evaluated by unconditional logistic regression.
Results: As a continuous variable, decreased creatinine clearance (CrCI) calculated by CG with actual body weight was associated with increased odds of CRT (OR 1.12, P < 0.01; 95% CI 1.04-1.20) indicating that on average for every 10 mL/min decrease in CrCI the odds of CRT increased by 12%. Very low RF (in the lowest 10%) with all formulas (CG, Jelliffe, Wright and MDRD) was associated with increased odds for CRT. This association is independent of the type of chemotherapy received (those requiring dose adjustment for renal function vs not). Neither primary dose reduction nor chemotherapy duration was associated with CRT. Serum creatinine alone was not associated with increased odds of CRT (OR 0.67, P = 0.15).
Conclusions: Decreased RF is associated with increased odds of CRT and should be considered when assessing risk of CRT in older adults with cancer. Serum creatinine alone is not adequate for risk assessment.

• 出版日期2017-3