title: [Monitoring renal function in patients treated with cytostatics].
abstract: BACKGROUND
  Some cytostatics, used in the treatment of cancer, are excreted by the kidneys and may be nephrotoxic. The glomerular filtration rate (GFR) represents a method for reliable assessement of the 51Cr-EDTA plasma clearance before and during treatment with nephrotoxic drugs. The aim of this retrospective study was to evaluate whether this method could be replaced by a more simplified GFR estimate calculated from the creatinine plasma concentration.
  
  
  METHODS
  We included all patients who had had at least four GFR measurements in 2005 as part of their nephrotoxic cytostatic treatment. The estimated GFR (eGFR) was calculated from sex, age and weight, according to the Cockcroft formula.
  
  
  RESULTS
  Forty-eight patients with a mean age of 47 years were included. 51Cr-EDTA plasma clearance and eGFR showed a poor correlation (r(2) = 0,678). On average, GFR decreased from 95 ml/min to 80 ml/min from the first to the fourth measurement, whereas plasma concentration of creatinine and eGFR remained unchanged. In 13 patients (27%), the treatment dose was reduced due to a fall in GFR. Seven of these 13 patients would have continued their treatment unchanged, if the clinical decision had been based on eGFR.
  
  
  CONCLUSIONS
  Neither creatinine plasma concentration nor estimated GFR ad modum Cockcroft can be recommended for measurement of GFR in patients treated with nephrotoxic cytostatics.
authors.affiliation: Klinisk Fysiologi og Nuklearmedicin, Arhus Universitetshospital, Arhus Sygehus, DK-8000 Arhus C. l_broendt@hotmail.com
authors.forename: Louise Brøndt
authors.initials: LB
authors.lastname: Hartlev
authors.forename: Charlotte Bøje
authors.initials: CB
authors.lastname: Rotbøl
authors.forename: Henrik
authors.initials: H
authors.lastname: Bluhme
authors.forename: Torben
authors.initials: T
authors.lastname: Palshof
authors.forename: Michael
authors.initials: M
authors.lastname: Rehling
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism; D002860:Chromium Radioisotopes / Q000493:pharmacokinetics; D003404:Creatinine / Q000097:blood; D004492:Edetic Acid / Q000493:pharmacokinetics; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D002860:Chromium Radioisotopes; D004492:Edetic Acid; D003404:Creatinine