Assessment and management of renal impairment in chemotherapy for urogenital cancer

Jpn J Clin Oncol. 2013 Nov;43(11):1055-63. doi: 10.1093/jjco/hyt132. Epub 2013 Sep 12.

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.

Keywords: anti-VEGF therapy; chemotherapy; chronic kidney disease; estimated glomerular filtration rate; urogenital cancer.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Carboplatin / administration & dosage
  • Carboplatin / adverse effects
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / adverse effects
  • Deoxycytidine / analogs & derivatives
  • Gemcitabine
  • Glomerular Filtration Rate / drug effects*
  • Humans
  • Incidence
  • Kidney / drug effects*
  • Male
  • Renal Insufficiency, Chronic / chemically induced*
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / epidemiology
  • Survival Rate
  • Testicular Neoplasms / drug therapy
  • Urogenital Neoplasms / drug therapy*
  • Urothelium

Substances

  • Deoxycytidine
  • Carboplatin
  • Cisplatin
  • Gemcitabine