Monitoring of renal function in cancer patients: an ongoing challenge for clinical practice

Ann Oncol. 2007 May;18(5):950-8. doi: 10.1093/annonc/mdm055. Epub 2007 Mar 9.


Background: Renal impairment (RI) has been shown to be one major risk factor in a number of diseases and is associated with a dismal clinical outcome. However, the influence of milder degrees of renal disease is less well defined, particularly not in patients with malignant diseases.

Patients and methods: We analyzed 167 patients with solid tumors and hematological malignancies. Besides disease-specific parameters, serum creatinine, cystatin C and the estimated glomerular filtration rate (eGFR) ['modification of diet in renal disease' equation (MDRD)/Cockcroft-Gault (CG)] were determined. Patients were compared within eGFR, creatinine and cystatin C groups.

Results: The median MDRD, CG, creatinine and cystatin C levels of all patients were 88 ml/min/1.73 m2, 89 ml/min, 1 mg/dl and 0.9 mg/l, respectively. Patients with chronic kidney disease stage 2 still showed normal creatinine and cystatin levels of 1 mg/dl and 1.1 mg/l, respectively, although mild RI was frequent. Those cancer patients with decreased eGFR (MDRD) (<60 ml/min/1.73 m2) had increased odds ratios (ORs) to have more concurrent diagnoses [OR 3.4; 95% confidence interval (CI) 1.5-8.1], a body mass index >24 kg/m2 (OR 2.1; 95% CI 1.0-4.5) and an elevated (> 245 pg/ml) pro-brain natriuretic peptide level (proBNP) (OR 9.2; 95% CI 3.0-28.3).

Conclusions: These observations suggest that grouping cancer patients according to renal function, especially eGFR, may be one way to determine specific risk groups.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Body Mass Index
  • Chronic Disease
  • Creatinine / blood
  • Cystatin C
  • Cystatins / blood
  • Female
  • Glomerular Filtration Rate / physiology*
  • Hematologic Neoplasms / pathology*
  • Humans
  • Kidney Diseases / classification
  • Kidney Diseases / physiopathology*
  • Kidney Diseases / therapy
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Monitoring, Physiologic*
  • Natriuretic Peptide, Brain / blood
  • Neoplasms / classification
  • Neoplasms / pathology*
  • Protein Precursors / blood


  • Biomarkers
  • CST3 protein, human
  • Cystatin C
  • Cystatins
  • Protein Precursors
  • Natriuretic Peptide, Brain
  • Creatinine