title: Is renal thrombotic angiopathy an emerging problem in the treatment of ovarian cancer recurrences?
abstract: OBJECTIVE
  Ovarian cancer is usually diagnosed at an advanced stage, with most patients undergoing surgery followed by platinum- and taxane-based chemotherapy. After initial clinical remission, the majority recur, leading to additional treatments, including not only platinums and taxanes but also pegylated liposomal doxorubicin (PLD), gemcitabine, topotecan, and, more recently, bevacizumab, which may extend survival times. PLD, in particular, has been extensively studied by our group, with encouraging therapeutic results. We, however, observed instances of chronic kidney disease (CKD) developing among patients who received long-term treatment for recurrent ovarian cancer. To document the frequency and contributing factors to the emergence of CKD, we initiated a retrospective review at two institutions.
  
  
  METHODS
  Fifty-six consecutive patients with recurrent ovarian cancer receiving treatment at New York University Cancer Institute were reviewed for the presence of renal disease in 1997-2010. At Shaare Zedek Medical Center, 73 consecutive patients with ovarian cancer were reviewed in 2002-2010. Patients were diagnosed with CKD if they had an estimated GFR <60 mL/minute per 1.73 m2 for >3 months and were staged according to the National Kidney Foundation guidelines.
  
  
  RESULTS
  Thirteen patients (23%) developed stage ≥3 CKD. Three patients had renal biopsies performed that showed thrombotic microangiopathy.
  
  
  CONCLUSIONS
  CKD is emerging as a potential long-term consequence of current chemotherapy for recurrent ovarian cancer.
authors.affiliation: NYU Clinical Cancer Center, 550 First Avenue, New York, NY 10016, USA.
authors.forename: Maryann
authors.initials: M
authors.lastname: Kwa
authors.forename: Robert
authors.initials: R
authors.lastname: Baumgartner
authors.forename: Linda
authors.initials: L
authors.lastname: Shavit
authors.forename: Irina
authors.initials: I
authors.lastname: Barash
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Michael
authors.forename: Igor
authors.initials: I
authors.lastname: Puzanov
authors.forename: Juri
authors.initials: J
authors.lastname: Kopolovic
authors.forename: Ora
authors.initials: O
authors.lastname: Rosengarten
authors.forename: Stephanie
authors.initials: S
authors.lastname: Blank
authors.forename: John P
authors.initials: JP
authors.lastname: Curtin
authors.forename: Alberto
authors.initials: A
authors.lastname: Gabizon
authors.forename: Franco
authors.initials: F
authors.lastname: Muggia
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects; D000068258:Bevacizumab; D003404:Creatinine / Q000097:blood; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D010984:Platinum / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects; D011788:Quality of Life; D012008:Recurrence; D051436:Renal Insufficiency, Chronic / Q000209:etiology / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D043823:Taxoids / Q000627:therapeutic use; D013927:Thrombosis / Q000209:etiology / Q000473:pathology*; D019772:Topotecan / Q000008:administration & dosage / Q000009:adverse effects; D000093542:Gemcitabine
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D043823:Taxoids; C506643:liposomal doxorubicin; D003841:Deoxycytidine; D000068258:Bevacizumab; D011092:Polyethylene Glycols; D010984:Platinum; D019772:Topotecan; D004317:Doxorubicin; D003404:Creatinine; D000093542:Gemcitabine