Abstract
Background: Malignancy or its treatment can produce a variety of renal diseasesand renal insufficiency frequently complicates malignancy and its treatment. The aim of this study is to assess the effect of different chemotherapeutic agents on the renal function of patients receiving treatment in a tertiary institution in Nigeria.
Methodology: This is a retrospective study of Glomerular filtration rate assessment among patients who received chemotherapy in Lagos University Teaching Hospital, Lagos, Nigeria from December, 2012 to November, 2013.
Results: 473cases were studied. The mean age was 50+ 15.5 years. The peak age range was 4th decade 123(26%). Commom cancers treated were breast cancer (159 cases), cervical cancer (103 cases) and prostate (35 cases). Stages recorded were stage III, 193(40.8%), stage II, 150 (31.7%), stage IV, 115 (24.3%), stage I, 15(3.2%). Treatment modalities revealed that 115(24.2%) had a combination of surgery and chemotherapy, 106 (22.4%) had chemotherapy alone, while 103 (21.8%) had a combination of surgery, chemotherapy and radiation therapy. There was a marked decrease in average GFR from 106.92 at beginning of treatment to 70.49 after completion of chemotherapy. The use of cisplatin showed the highest reduction in the GFR(43 %)after completion of chemotherapy.
Conclusion: Renal Insufficiency is common in cancer patients and drug dosage adjustments might be necessary. Renal function should be evaluated in all cancer patients in a bid to identify patients with a high risk for drug toxicity.
Keywords: Renal, Insufficiency, Cancer
Résumé
Contexte: La malignité ou son traitement peut produire une variété de maladies rénales et l’insuffisance rénale complique fréquemment la malignité et son traitement. Le but de cette étude est d’évaluer l’effet de différents agents chimio-thérapeutiques sur la fonction rénale des patients recevant un traitement dans un établissement tertiaire au Nigeria.
Méthodologie: Ceci est une étude rétrospective de l’évaluation du taux de filtration glomérulaire parmi les patients qui ont reçu une chimiothérapie à l’Hôpital d’Enseignement Universitaire deLagos, Lagos, au Nigeria de décembre 2012 à novembre 2013.
Résultats: 473 cas ont été étudiés. L’âge moyen était de 50±15,5 ans. La tranche d’âge maximale était la 4 eme décennie 123 (26%). Les cancers communs traités étaient le cancer du sein (159 cas), le cancer du col de l’utérus (103 cas) et la prostate (35 cas). Les phasesenregistrées étaient laphase III, 193 (40,8%), phase II, 150 (31,7%), phase IV, 115 (24,3%), phase I, 15 (3,2%). Les modalités de traitement ont révélé que 115 (24,2%) avaientune combinaison de chirurgieet de chimiothérapie, 106 (22,4%) avaientuniquement la chimiothérapie, tandis que 103 (21,8%) avaient une combinaison de chirurgie, de chimiothérapie et de radiothérapie. Il y avait une diminution marquée du TFG moyen de 106,92 au début du traitement à 70,49 après l’achèvement de la chimiothérapie. L’utilisation du cisplatin a montré la plus forte réduction du TFG (43%) après achèvement de la chimiothérapie.
Conclusion: L’insuffisance rénale est fréquente chez les patients atteints du cancer et des ajustements posologiques peuvent être nécessaires. La fonction rénale doit être évaluée chez tous les patients atteints du cancer dans le but d’identifier les patients présentant un risque élevé de toxicité médicamenteuse.
Mots-clés: Rénale,Insuffisance, Cancer
Correspondence: Dr. Anthonia C. Sowunmi, Department of Radiotherapy and Oncology, Lagos University Teaching Hospital, Idi.Araba, Lagos, Nigeria. E-mail: toniasow@yahoo.com
References
Humphreys BD, Soiffer RJ and Magee CC, Renal failure associated with cancer and its treatment: an update.SOJ Am Soc. Nephrol. 2005; 16(1):151.
Dogan E, Izmirli M and CeylanK, Incidence of Renal Insufficiency in Cancer Patients, Advances in Therapy 2005.22:4.
Garnick M B and Mayer RJ: Management of Acute renal failure associated with neoplastic disease. In Yarbm J. Bornstein R (eds): Oncologic Emergencies. Management of Acute Renal Failure Associated With Neoplastic Disease. Orlando. FL. Grune and Stranon, 1981-247-271.
Weiss RB and Poster DS: The renal toxicity of cancer chemotherapeutic agents. Cancer Treat Rev 1982:9:37-57.
Abelson H T and Garnick M B: Renal failure induced by cancer chemotherapy, in Rieselbach RE. Garnick MB (eds): Cancer and the Kidney. Philadelphia. Lea and Febiger. 1982;769-813
Ries F and Klastersky J. Nephrotoxicity Induced by Cancer Chemotherapy with Special Emphasis on Cisplatin Toxicity. American Journal of Kidney diseases.1986 (5); 368-379
Flombaum C.D. Nephrotoxicity of chemotherapy agents and chemotherapy administration in patients with renal disease in Cancer and the Kidney: The frontier of nephrology and oncology (2 edition.).Oxford University Press Print Publication 2010.
Marx GM, Blake GM, Galani E, et al. Evaluation of the Cockroft-Gault, Jelliffe and Wright formulae in estimating renal function in elderly cancer patients mass. Ann Oncol. 2004; 15:291-295.
Cockcroft DW and Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976; 16:31-41.
Rossini .B, Jean-Pierre .M, Cecilé .C et al, Estimating Glomerular Filtration Rate: Cockcroft–Gault and Modification of Diet in Renal Disease Formulas Compared to Renal Inulin Clearance, Clin J Am Soc. Nephrol. 2009; 4(5): 899–906.
Jedy-Agba E1, Curado MP, Ogunbiyi O etal. Cancer incidence in Nigeria: a report from population-based cancer registries. Cancer Epidermiolol2012; 36(5):271-278.
TevfikDorak .M and Karpuzoglu.E, Gender Differences in Cancer Susceptibility: An Inadequately Addressed Issue, Front Genet. 2012; 3: 268.
Cancer Rates by Race/Ethnicity and Sex, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, reviewed: August 27, 2014, updated: August 20, 2015. Available from: http://www.cdc.gov/cancer/dcpc/data/race.htm.
Cancer Research UK. Cancer incidence by age, Cancer Research UK, Available from:http://www.cancerresearchuk.org/health-professional/cancer statistics/incidence/age#heading-Zero, 2015.
Akinde. O.R, Phillips. A.A, Oguntunde .O.A. Cancer Mortality Pattern in Lagos University Teaching Hospital, Lagos, Nigeria,Journal of Cancer Epidemiology, 2015; 842032: 6.
Kene T.S, Odigie V.I and Yusufu L. Pattern of Presentation and Survival of Breast Cancer in a Teaching Hospital in North Western Nigeria, Oman Med J. 2010 , 25(2): 104–107.
Agbo P S , Khalid A and Oboirien M .Clinical Presentation, Prevalence and Management of Breast Cancer in Sokoto, Nigeria, Journal of Women’s Health Care. 2014; 102-209
Pabla N and Dong Z: Cisplatin nephrotoxicity: Mechanisms and renoprotective strategies. Kidney Int. 2008: 994–1007.
Kawai Y, Nakao T, Kunimura N, Kohda Y and Gemba M: Relationship of intracellular calcium and oxygen radicals to Cisplatin-related renal cell injury. J PharmacolSci. 2006; 100: 65–72.
Perazella M.A. Onco-Nephrology: Renal Toxicities of Chemotherapeutic Agents. Clinical Journal of American Society of Nephrology. 2012; 7(10) 1713-1721.