Assessment of glomerular filtration rate in cancer patients

• Grant number: 17/25417-2
• Support Opportunities: Scholarships abroad - Research
• Start date: June 10, 2019
• End date: May 21, 2020
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Verônica Torres da Costa e Silva
• Grantee: Verônica Torres da Costa e Silva
• Host Investigator: Lesley Ann Inker
• Host Institution: Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira (ICESP). Coordenadoria de Serviços de Saúde (CSS). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Institution abroad: Tufts University, United States
• Associated research grant: 14/19286-4 - Individuals with high risk for acute kidney injury development in clinical relevant situations: a prospective study on epidemiological, diagnostic and prognostic aspects, AP.TEM

Abstract

An accurate assessment of GFR is crucial in cancer patients in order to provide a precise instrument to adjust chemotherapy drugs doses according to renal function, avoiding renal and systemic toxicities. Estimation of the glomerular filtration rate (eGFR) through equations based on serum creatinine (SCr) is considered the most suitable method for GFR evaluation. However, these equations were not validated in cancer patients and the most accurate method to assess GFR in cancer patients has not been established. The aims of this study are: a) to assess the accuracy of CKD-EPI equation (comparing creatinine, cystatin and both creatinine and cystatin-based equations variations) in cancer patients, compared to a reference method (radioisotopic clearance of 51Cr-EDTA; b) to compare the performance of three equations used to assess GFR (Cockroft-Gault, MDRD, EPI-CKD) in these patients; c) to assess the accuracy of these equations for the prescription of chemotherapeutic drugs with renal excretion, using as reference the radioisotopic clearance of 51Cr-EDTA and if dose differences are related to clinical and oncologic outcomes; d) to evaluate the prevalence of CKD in these patients. For that, 1,250 patients initiating treatment at ICESP will be prospectively assessed. All patients will perform a GFR evaluation through 51Cr-EDTA, assessment of serum levels of creatinine, beta-2-microglobulin and beta-trace-protein and urine albumin-to-creatinine ratio (mg/g, random untimed urine sample) before starting treatment. We will exclude patients younger than 18 years old, patients with benign tumors, hematologic cancers, patients with poor performance status (ECOG-PS> 2), patients under chronic renal replacement therapy program, pregnant and nursing women. (AU)