Русский
Prevalence of chronic kidney disease among cancer patients
DOI: https://dx.doi.org/10.18565/pharmateca.2023.11.88-93
T.N. Trofimtseva, S.K. Yarovoy, A.A. Gritskevich
1) Loginov Moscow Clinical Research Center, Moscow, Russia; 2) Lopatkin Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Center of Radiology, Moscow, Russia; 3) Vishnevsky National Medical Research Center for Surgery, Moscow, Russia; 4) Patrice Lumumba Peoples’ Friendship University of Russia, Moscow, Russia
Background. Information on the incidence, causes and severity of chronic kidney disease (CKD) in patients requiring antitumor drug therapy is limited in the literature. However, this information is essential for practical oncology and for the continuation of scientific research.
Objective. Evaluation of the CKD incidence among patients seeking oncological care, as well as its distribution by stage and relationship with oncological nosologies.
Methods. A retrospective study based on the analysis of medical records of 1500 patients followed-up at the City Clinical Hospital named after D.D. Pletnev in 2021 was conducted. The study included all patients who had a verified diagnosis of a malignant neoplasm. There were no exclusion criteria. Patients were divided into groups according to oncological diagnosis, the fact of pathogenetic antitumor therapy, CKD stage, and the main cause of renal failure (RF). Renal filtration function was assessed using CKD-EPI nomograms.
Results. A decrease in renal filtration was observed in 33% of oncological patients. In terms of incidence, CKD stage II and IIIa prevailed – 44.64 and 28.97%, respectively. Among oncological nosologies, CKD was most often observed in cancer of the kidney (21.21%), prostate (18.79%), bladder (16.97%), cervix (11.92%) and ovarian (9.09%). Irreversible renal pathology (nephrangiosclerosis, chronic pyelonephritis), a determining factor in the genesis of CKD, occurred in 54.08% of patients. Renal failure due to severe tumor intoxication was noted in 6.87% of patients.
Conclusion. CKD in oncological patients was common (33% of the total), mainly in the initial stages (II and IIIa – a total of 73.61%) and, mainly, in patients with urological and oncological gynecological profiles (a total of 77. 98%).
The main reasons for the deficiency of filtration function include concomitant chronic kidney pathology (nephrangiosclerosis, chronic pyelonephritis) and side effects of drug therapy (in total, 77.04%).
Objective. Evaluation of the CKD incidence among patients seeking oncological care, as well as its distribution by stage and relationship with oncological nosologies.
Methods. A retrospective study based on the analysis of medical records of 1500 patients followed-up at the City Clinical Hospital named after D.D. Pletnev in 2021 was conducted. The study included all patients who had a verified diagnosis of a malignant neoplasm. There were no exclusion criteria. Patients were divided into groups according to oncological diagnosis, the fact of pathogenetic antitumor therapy, CKD stage, and the main cause of renal failure (RF). Renal filtration function was assessed using CKD-EPI nomograms.
Results. A decrease in renal filtration was observed in 33% of oncological patients. In terms of incidence, CKD stage II and IIIa prevailed – 44.64 and 28.97%, respectively. Among oncological nosologies, CKD was most often observed in cancer of the kidney (21.21%), prostate (18.79%), bladder (16.97%), cervix (11.92%) and ovarian (9.09%). Irreversible renal pathology (nephrangiosclerosis, chronic pyelonephritis), a determining factor in the genesis of CKD, occurred in 54.08% of patients. Renal failure due to severe tumor intoxication was noted in 6.87% of patients.
Conclusion. CKD in oncological patients was common (33% of the total), mainly in the initial stages (II and IIIa – a total of 73.61%) and, mainly, in patients with urological and oncological gynecological profiles (a total of 77. 98%).
The main reasons for the deficiency of filtration function include concomitant chronic kidney pathology (nephrangiosclerosis, chronic pyelonephritis) and side effects of drug therapy (in total, 77.04%).
Keywords: oncological care, kidney cancer, bladder cancer, cervical cancer, prostate cancer, chronic kidney disease, acute kidney injury
About the Autors
Corresponding author: Aleksandr A. Gritskevich, Dr. Sci. (Med.), Head of the Department of Surgical Treatment of Urological Diseases, Professor at the Educational Department, Vishnevsky National Medical Research Center for Surgery; Professor at the Department of Urology and Operative Nephrology with a Course of Oncourology, Patrice Lumumba Peoples’ Friendship University of Russia, Moscow, Russia; grekaa@mail.ru
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