title: Assessment and management of renal impairment in chemotherapy for urogenital cancer.
abstract: The method of diagnosing chronic kidney disease by simple estimated glomerular filtration rate equations has demonstrated a high prevalence of chronic kidney disease among the genitourinary cancer patients. Approximately 30-50% of urothelial cancer patients have Grade 3 chronic kidney disease before chemotherapy, and the rate increases to around 80% in upper urinary tract cancer patients who have undergone radical surgery. Several gold-standard treatments, including cisplatin for urothelial/testicular tumors and anti-vascular endothelial growth factor therapy for kidney cancers, are known to be associated with the development of renal impairment. However, which renal function assessments are best to select a chemotherapy regimen remain unknown. Most testicular tumor patients are cured by intensive combined chemotherapy with cisplatin, but chemotherapy can induce chronic kidney disease in testicular cancer survivors. The prevalence of Stage 3 chronic kidney disease among the testicular cancer survivors is between 10 and 20%. Thus, the estimated glomerular filtration rate assessment is a useful tool for monitoring the development of chronic kidney disease among the cancer survivors, and assessment of renal function is mandatory before the treatment of these genitourinary cancer patients.
authors.affiliation: *Department of Urology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki 305, Japan. rkawa@md.tsukuba.ac.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Kawai
authors.forename: Daishi
authors.initials: D
authors.lastname: Ichioka
authors.forename: Hiromu
authors.initials: H
authors.lastname: Inai
authors.forename: Jun
authors.initials: J
authors.lastname: Miyazaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishiyama
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000187:drug effects*; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000188:drug therapy; D014565:Urogenital Neoplasms / Q000188:drug therapy*; D019459:Urothelium; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D016190:Carboplatin; D002945:Cisplatin; D000093542:Gemcitabine
keywords: anti-VEGF therapy; chemotherapy; chronic kidney disease; estimated glomerular filtration rate; urogenital cancer