Prevalence of renal insufficiency in cancer patients: Data from the IRMA-2 study

Abstract

9559 Background: The IRMA-1 study reported the high prevalence of renal insufficiency (RI) in 4,684 cancer patients, with a glomerular filtration rate (GFR) <90 and <60 ml/min/1.73m2 for 52.9% and 12.0%, respectively. Furthermore, almost 80% of patients were receiving nephrotoxic drugs or drugs necessitating dosage adjustment. The IRMA-2 study was started one year later, in different patients, and consisted of 2 phases: 1) a cross-sectional study, similar to IRMA-1, and 2) a 2-year retrospective follow-up of the patients to describe the evolution of their renal function along with time. Data from the phase 1 were compared to the results of IRMA-1 in terms of RI prevalence. Methods: Data were collected for cancer patients presenting at one of the 19 IRMA-2 centers in March 2005: type of tumour, sex, age, weight, serum creatinine (SCR), and anticancer drugs. Dialysis, myeloma and lymphoma patients were not included. The prevalence of SCR>110 μmol/L was assessed. GFR was estimated with the aMDRD formula, anticancer drugs necessitating dosage adjustment and those potentially nephrotoxic were identified. Results: 4,945 patients (breast 1816, colorectal 747, lung 463, ovarian 294, prostate 251) were included in the IRMA-2 study. Median age 60.0, mean weight 66.2, 62.8% were women. The prevalence of an elevated SCR (SCR>110μmol/l) was 7.2% (vs. 7.2% in IRMA-1), that of a GFR < 90 ml/min/1.73m2 was 50.2% (vs. 52.9%) and that of a GFR < 60 ml/min/1.73m2 was 11.9% (vs. 12.0%) ( Table ). 73.2% of treated patients (n=3882) were receiving at least one drug needing dosage adjustment and 75.5% received at least one nephrotoxic drug (vs. 79.9 and 80.1%, respectively). Conclusions: The results of IRMA-2 and IRMA-1 confirm the high prevalence of RI in cancer patients, on 2 different cohorts of nearly 5,000 cancer patients each. This underlines that estimating renal function in cancer patients is mandatory and that this highly frequent co-morbidity should be considered. [Table: see text] No significant financial relationships to disclose.