title: Association between renal function and chemotherapy-related toxicity in older adults with cancer.
abstract: To evaluate the association between renal function (RF) and chemotherapy-related toxicity (CRT) in older adults with cancer and to compare the effect of different RF formulas and body weight measurements on this association.
  
  
  
  This is a secondary analysis of data from a prospective multicenter study of patients ≥ age 65 who were starting a new chemotherapy regimen. RF was estimated with 4 formulas (modified Jelliffe [Jelliffe], Cockcroft-Gault [CG], Wright, and Modification of Diet in Renal Disease [MDRD]), using actual, ideal and adjusted body weights for 492 patients. The association between baseline RF and grade 3-5 CRT was evaluated by unconditional logistic regression.
  
  
  
  As a continuous variable, decreased creatinine clearance (CrCl) calculated by CG with actual body weight was associated with increased odds of CRT (OR 1.12, P<0.01; 95% CI 1.04-1.20) indicating that on average for every 10mL/min decrease in CrCl the odds of CRT increased by 12%. Very low RF (in the lowest 10%) with all formulas (CG, Jelliffe, Wright and MDRD) was associated with increased odds for CRT. This association is independent of the type of chemotherapy received (those requiring dose adjustment for renal function vs not). Neither primary dose reduction nor chemotherapy duration was associated with CRT. Serum creatinine alone was not associated with increased odds of CRT (OR 0.67, P=0.15).
  
  
  
  Decreased RF is associated with increased odds of CRT and should be considered when assessing risk of CRT in older adults with cancer. Serum creatinine alone is not adequate for risk assessment.
authors.affiliation: Washington University School of Medicine, St. Louis, MO, United States. Electronic address: llpeterson@wustl.edu.
authors.forename: Lindsay L
authors.initials: LL
authors.lastname: Peterson
authors.affiliation: City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA, United States.
authors.forename: Arti
authors.initials: A
authors.lastname: Hurria
authors.affiliation: City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA, United States.
authors.forename: Tao
authors.initials: T
authors.lastname: Feng
authors.affiliation: University of Rochester, Rochester, NY, United States.
authors.forename: Supriya G
authors.initials: SG
authors.lastname: Mohile
authors.affiliation: Case Western Reserve University, Cleveland, OH, United States.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Owusu
authors.affiliation: Wake Forest University School of Medicine, Winston-Salem, NC, United States.
authors.forename: Heidi D
authors.initials: HD
authors.lastname: Klepin
authors.affiliation: Yale Comprehensive Cancer Center, New Haven, CT, United States.
authors.forename: Cary P
authors.initials: CP
authors.lastname: Gross
authors.affiliation: Memorial Sloan-Kettering Cancer Center, United States.
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Lichtman
authors.affiliation: State University of New York Upstate Medical University and Veterans Administration Medical Center, Syracuse, NY, United States.
authors.forename: Ajeet
authors.initials: A
authors.lastname: Gajra
authors.affiliation: Memorial Sloan-Kettering Cancer Center, United States.
authors.forename: Ilya
authors.initials: I
authors.lastname: Glezerman
authors.affiliation: City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA, United States.
authors.forename: Vani
authors.initials: V
authors.lastname: Katheria
authors.affiliation: City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA, United States.
authors.forename: Laura
authors.initials: L
authors.lastname: Zavala
authors.affiliation: City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA, United States.
authors.forename: David D
authors.initials: DD
authors.lastname: Smith
authors.affiliation: City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA, United States.
authors.forename: Can-Lan
authors.initials: CL
authors.lastname: Sun
authors.affiliation: Memorial Sloan-Kettering Cancer Center, United States.
authors.forename: William P
authors.initials: WP
authors.lastname: Tew
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001835:Body Weight; D003401:Creatine / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced*; D007677:Kidney Function Tests; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents; D003401:Creatine
keywords: Chemotherapy toxicity; Creatinine clearance; Older adults; Renal function