Administration of chemotherapy in patients on dialysis.
The prevalence of patients on dialysis has increased and these patients present a challenge for chemotherapy administration when diagnosed with cancer. A consensus on the dosage and timing of different chemotherapeutic agents in relation to dialysis has not been established. We describe the pattern of care and treatment outcome for cancer patients on dialysis in our institution. The dataset from the Australia and New Zealand Dialysis and Transplant Registry of patients on dialysis who had a diagnosis of cancer was obtained and matched to the pharmacy records in our institution to identify patients who had received chemotherapy while on dialysis. Relevant clinical information including details of the dialysis regimen, chemotherapy administration and adverse events was extracted for analysis. Between July 1999 and July 2014, 21 patients on dialysis were included for analysis. Five (23.8%) received chemotherapy, most of which was administered before dialysis sessions. As a result of adverse events, one patient discontinued treatment; two other patients required dose reduction or treatment delay. Chemotherapy administration was feasible in cancer patients on dialysis, but chemotherapy usage was low. Better understanding of the altered pharmacokinetics in patients on dialysis may improve chemotherapy access and practice.
aDepartment of Medical Oncology, The Canberra Hospital bANU Medical School, Australian National University, Canberra, Australian Capital Territory, Australia.
James C
JC
Kuo
Paul S
PS
Craft
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D009373:Neoplasms, Germ Cell and Embryonal / Q000150:complications / Q000188:drug therapy; D018307:Neoplasms, Squamous Cell / Q000150:complications / Q000188:drug therapy; D010307:Parotid Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D006435:Renal Dialysis; D012878:Skin Neoplasms / Q000150:complications / Q000188:drug therapy; D055752:Small Cell Lung Carcinoma / Q000150:complications / Q000188:drug therapy; D013736:Testicular Neoplasms / Q000150:complications / Q000188:drug therapy