Clinical questions and good practice statements of clinical practice guidelines for management of kidney injury during anticancer drug therapy 2022
Year: 2023
Type: article
Abstract: Glomerular filtration rate • Acute kidney injury • Anticancer drug therapy • Immune checkpoint inhibitors • Cancer survivorspatients with cancer; thus, their validity for patients receiving cancer pharmacotherapy remain uncertain. Target and methodTherefore, in response to the CQ "Is the use of estimation formulae recommended for assessing renal function (GFR) in patients with cancer?" we conducted a SR of the accuracy assessment of eGFR values, using measured GFR values as controls.The outcome was the accuracy of the eGFR value; and P30, which is defined as "the ratio of cases where the eGFR value is within ± 30% of the measured GFR value," was used as the method of evaluation.P30 is used in systematic reviews evaluating GFR estimation formulae in patients with diabetes, those who have undergone kidney transplantation, and those with cirrhosis, and it is recommended as a method of evaluation for GFR estimation in the KDOQI and KDIGO guidelines.By sending a request to the Japan Medical Library Association, we had papers that evaluated measured GFR and eGFR using P30 extracted from the databases of PubMed, Cochrane, and the Japan Medical Abstracts Society.The two reports by Funakoshi et al. were the only publications that studied Japanese patients with cancer and GFR estimation formulae developed by the JSN [9,10], while most of other papers evaluated CKD-EPI, Modification of Diet in Renal Disease (MDRD), and Cockcroft-Gault developed in the United States.Therefore, a meta-analysis was conducted on nine papers evaluating the accuracy of the CKD-EPI formula, which is currently the most widely used worldwide [10][11][12][13][14][15][16][17][18].The collective estimate was 81% (95% confidence interval (CI): 71-91%).The KDOQI considered a P30 value of ≥ 75% to be sufficient for clinical decision, while the recommended target is ≥ 90%.The result of the meta-analysis of the nine papers in this study was 81%; thus, it was considered appropriate.The I 2 value, which shows heterogeneity, was as high as 97.9%; notably, the characteristics of the patients (race and type of cancer), and method of GFR measurement varied among reports.Based on these factors, the strength of the evidence was deemed weak.
Authors: Motoko Yanagita, Satoru Muto, Hiroyuki Nishiyama, Yuichi Ando, Sumio Hirata, Kent Doi, Yutaka Fujiwara, Norio Hanafusa, Takahiro Hatta, Junichi Hoshino, Satoko Ichioka, Takamitsu Inoue, Kenji Ishikura, Taigo Kato, Hiroshi Kitamura, Yusuke Kobayashi, Yuichi Koizumi, Chihiro Kondoh, Takeshi Matsubara, Kazuo Matsubara, Koji Matsumoto, Yusuke Okuda, Yuta Okumura, Emiko Sakaida, Yugo Shibagaki, Hideki Shimodaira, Nao Takano, Akiko Uchida, Kimikazu Yakushijin, Takehito Yamamoto, Kazuhiro Yamamoto, Yoshinari Yasuda, Mototsugu Oya, Hirokazu Okada, Masaomi Nangaku, Naoki Kashihara
Institutions: Kyoto University, Institute for the Advanced Study of Human Biology, Kyoto University, Juntendo University, University of Tsukuba, Nagoya University Hospital, University of Tokyo Hospital, Aichi Cancer Center, Tokyo Women's Medical University, Anjo Kosei Hospital, Shiga University of Medical Science, International University of Health and Welfare Narita Hospital, Kitasato University, The University of Osaka, University of Toyama, Keio University, Fuchu Hospital, National Cancer Center Hospital East, Wakayama Medical University Hospital, Hyogo Prefectural Cancer Center, National Hospital Organization Kyushu Cancer Center, Chiba University Hospital, St. Marianna University School of Medicine, Tohoku Medical and Pharmaceutical University, Nagoya University, Seirei Sakura Citizen Hospital, Kobe University Hospital, Saitama Medical University, The University of Tokyo, Kawasaki Medical School
Language: English
Topic: Acute Kidney Injury Research
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,590
Funders: Japan Society of Clinical Oncology, Keio University, Kanazawa Medical University, University of Tokushima, Nara Medical University, Japanese Society of Medical Oncology, Jikei University School of Medicine, Chiba University, Kawasaki Medical School, Japan Society for the Promotion of Science
Awards: Biological analyses of BRCA1 gene missense variants for application to cancer genome medicine, Renal plasma flow (RPF) and accurate GFR equations utilizing metabolomics analysis, Pathologic analysis of tertiary lymphoid tissue in acute interstitial nephritis associated with immune-checkpoint inhibitor, Functional assay to estimate the significance of variants in CDKN2A gene detected in cancer genome testing
OpenAlex ID: W4387931379