title: Renal function evaluation in patients with cancer who were scheduled to receive carboplatin or S-1.
abstract: BACKGROUND
  Accurate glomerular filtration rate (GFR) evaluation is significant for drug dosing of carboplatin, anticancer drug excreted mainly from kidney. Serum cystatin-C (sCys-C) is a GFR marker with little affected by body muscle mass volume. And GFR equations based on serum creatinine (eGFRcreat) and sCys-C (eGFRcys) were developed; however, accuracy of eGFRcys has not been elucidated fully among patients with cancer. Therefore, we analyzed the performance of GFR equations among patients with cancer whose GFR values were measured by inulin clearance (Cin).
  
  
  METHODS
  Study design was a cross-sectional study. Subjects were 41 patients with cancer whose GFR values were measured by Cin for drug dosing studies of carboplatin or S-1 in Nagoya University Hospital from 2007 to 2010 and 29 non-cancer patients. Correlation with Cin and slope of regression line were evaluated in eGFRcreat and eGFRcys. Single and multiple regression analyses were analyzed to identify associating factors with eGFRcreat/Cin or eGFRcys/Cin.
  
  
  RESULTS
  Age, body weight, body mass index (BMI) and sCr were different between cancer patients and non-cancer patients, but sCys-C and Cin were consistent in 2 groups. The slope of the regression line for Cin vs. eGFRcys with zero intercept in cancer patients was 1.10 (95 % CI: 1.02-1.17), which was significantly different from 1.0. In multiple regression analysis revealed that BMI and urinary creatinine excretion were significantly associated with eGFRcreat/Cin, and cancer was only associating factor with eGFRcys/Cin.
  
  
  CONCLUSIONS
  eGFRcys should not be used for evaluation of renal function in patients with cancer because it underestimates GFR.
authors.affiliation: Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.|Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Shibata
authors.affiliation: Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. yyasuda@med.nagoya-u.ac.jp.|Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan. yyasuda@med.nagoya-u.ac.jp.
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Yasuda
authors.affiliation: Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Kobayashi
authors.affiliation: Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ando
authors.affiliation: Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Shimokata
authors.affiliation: Division of Diabetes, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Kamiya
authors.affiliation: Department of Cardiology, Fujita Health University Second Hospital, Nagoya, Japan.
authors.forename: Mutsuharu
authors.initials: M
authors.lastname: Hayashi
authors.affiliation: Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Maruyama
authors.affiliation: Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Matsuo
authors.affiliation: College of Pharmacy, Kinjo Gakuin University, Nagoya, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakao
authors.affiliation: Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan.
authors.forename: Teruo
authors.initials: T
authors.lastname: Tsuchiya
authors.affiliation: Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Teramachi
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D015992:Body Mass Index; D016190:Carboplatin / Q000009:adverse effects / Q000627:therapeutic use*; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D055316:Cystatin C / Q000097:blood; D004338:Drug Combinations; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007444:Inulin / Q000378:metabolism; D007677:Kidney Function Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000503:physiopathology*; D010094:Oxonic Acid / Q000009:adverse effects / Q000627:therapeutic use; D011725:Pyridines / Q000009:adverse effects / Q000627:therapeutic use; D005641:Tegafur / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D055316:Cystatin C; D004338:Drug Combinations; D011725:Pyridines; C586502:tegafur-gimeracil-oteracil; D005641:Tegafur; D010094:Oxonic Acid; D007444:Inulin; D003404:Creatinine; D016190:Carboplatin
keywords: Cancer; Creatinine; Cystatin C; GFR equation; Japanese