Cancer and renal insufficiency results of the BIRMA study

Br J Cancer. 2010 Dec 7;103(12):1815-21. doi: 10.1038/sj.bjc.6605979. Epub 2010 Nov 9.

Abstract

Background: half of anticancer drugs are predominantly excreted in urine. Dosage adjustment in renal insufficiency (RI) is, therefore, a crucial issue. Moreover, patients with abnormal renal function are at high risk for drug-induced nephrotoxicity. The Belgian Renal Insufficiency and Anticancer Medications (BIRMA) study investigated the prevalence of RI in cancer patients, and the profile/dosing of anticancer drugs prescribed.

Methods: primary end point: to estimate the prevalence of abnormal glomerular filtration rate (GFR; estimated with the abbreviated Modification of Diet in Renal Disease formula) and RI in cancer patient. Secondary end point: to describe the profile of anticancer drugs prescribed (dose reduction/nephrotoxicity). Data were collected for patients presenting at one of the seven Belgian BIRMA centres in March 2006.

Results: a total of 1218 patients were included. The prevalence of elevated SCR (> or =1.2 mg per 100 ml) was 14.9%, but 64.0% had a GFR<90 ml min(-1) per 1.73 m(2). In all, 78.6% of treated patients (n=1087) were receiving at least one drug needing dosage adjustment and 78.1% received at least one nephrotoxic drug. In all, 56.5% of RI patients receiving chemotherapy requiring dose reduction in case of RI did not receive dose adjustment.

Conclusions: the RI is highly frequent in cancer patients. In all, 80% of the patients receive potentially nephrotoxic drugs and/or for which dosage must be adjusted in RI. Oncologists should check the appropriate dose of chemotherapeutic drugs in relation to renal function before prescribing.

MeSH terms

  • Adult
  • Aged
  • Anemia / etiology
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Bone Neoplasms / secondary
  • Creatinine / blood
  • Female
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Kidney / drug effects
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms / drug therapy*
  • Neoplasms / physiopathology
  • Renal Insufficiency / chemically induced
  • Renal Insufficiency / physiopathology*

Substances

  • Antineoplastic Agents
  • Creatinine