Geri̇atri̇k Onkonefroloji̇
Ergün Parmaksız, Serap YadigarYaş ilerledikçe hastalarda nefrolojik problemlerin sıklığı arttığı bilinmekte olup, aynı zamanda geriatrik onkoloji hasta grubunda da yıllar içinde istikrarlı bir artış göz önüne alındığında bu hastaların nefrolojik takibi ayrı bir yer tutmaktadır. Geriatrik nefro-onkoloji (GNO) hastalarında nefrolojinin rolü, malignitenin kendisinin veya tedavi yönetiminde ortaya çıkabilecek nefrolojik problemlerin ivedi bir şekilde çözülmesini sağlayıp hastanın ek bir problem ile karşılaşmasını önlemektir. GNO hastalarda böbrek fonksiyon testlerinin takibinde kreatinin, yaş, cinsiyet, nütrisyonel durum, kas kitlesinde değişikliklerden ötürü ve böbrek hasarı meydana geldikten 24 ile 72 saat sonra kreatinin değişikliği olduğundan tek başına kullanılmamalıdır1 . Cystatin C böbrek fonksiyonun değerlendirilmesinde kullanılmasına rağmen GNO hastalarda Cystatin C’nin maligniteden ve verilecek kemoterapötik ilaçlardan etkilenebileceğinden yeterince değerlendirme yapılmamıştır2 . Bu hastalarda glomerüler filtrasyon hızının (GFH) değerlendirilmesinde kreatinin klirensi ölçümü, tGFH ölçümleri, kanser spesifik denklemleri içerir. tGFH ölçümlerinde serum kreatinin ve cystatin C gibi endojen filtrasyon belirteçleri kullanılır. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) denklemi ile GFH ölçülmesinde ırk, yaş, cinsiyet, kreatinin değişiklerini kullanılır ve kanser hastalarında CKD-EPI kullanımı kohort çalışmalarda onaylanmıştır ve CKD-EPI diğer metodlara göre kanser hastalarında daha üstün olduğu gösterilmiştir3 . Bir istisna olarak carboplatin alacak hastalarda Calvert formülü kullanılmaktadır4 .
Referanslar
- 1. Kashani K, Rosner MH, Ostermann M. Creatinine: from physiology to clinical application. Eur J Intern Med. 2020;72:9-14. google scholar
- 2. Cavalcanti E, Barchiesi V, Cerasuolo D, et al. Correlations of serum cystatin C with glomerular filtration rate in patients receiving platinum-based chemotherapy. Anal Cell Pathol (Amst). 2016;2016:4918325 google scholar
- 3. Janowitz T, Williams EH, Marshall A, et al. New model for estimating glomerular filtration rate in patients with cancer. J Clin Oncol. 2017;35:2798-2805. google scholar
- 4- Jodrell DI, Egorin MJ, Canetta RM, et al. Relationships between carboplatin exposure and tumor response and toxicity in patients with ovarian cancer. J Clin Oncol. 1992;10:520-528. google scholar
- 5. Konigsbrugge O, Lotsch F, Zielinski C, Pabinger I, Ay C. Chronic kidney disease in patients with cancer and its association with occurrence of venous thromboembolism and mortality. Thromb Res. 2014;134:44-49. google scholar
- 6. Rosner MH, Jhaveri KD, McMahon BA, Perazella MA. Onconephrology: The intersections between the kidney and cancer. CA Cancer J Clin. 2021 Jan;71(1):47-77. doi: 10.3322/caac.21636. Epub 2020 Aug 27. PMID: 32853404. google scholar
- 7. US Renal Data System (USRDS). Chapter 5: Acute kidney injury. In: USRDS, ed. 2014 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States. Vol. 1. National Institutes of Health, National Institute of Diyabetes and Digestive and Kidney Diseases. USRDS; 2014:37-45. Accessed March 24, 2020. usrds.org/2014/view/v1_05.aspx google scholar
- 8. Christiansen CF, Johansen MB, Langeberg WJ, Fryzek JP, Sorensen HT. Incidence of acute kidney injury in cancer patients: a Danish population-based cohort study. Eur J Intern Med. 2011;22:399-406. google scholar
- 9. Liborio AB, Abreu KL, Silva GB Jr, et al. Predicting hospital mortality in critically ill cancer patients ac-cording to acute kidney injury severity. Oncology. 2011;80(3-4):160-166. google scholar
- 10. Howard SC, Jones DP, Pui CH. The tumor lysis syndrome. N Engl J Med. 2011;364:1844-1854. google scholar
- 11. Criscuolo M, Fianchi L, Dragonetti G, Pagano L. Tumor lysis syndrome: review of pathogenesis, risk fac-tors, and management of a medical emergency. Expert Rev Hematol. 2016;9:197-208 google scholar
- 12. Wilson FP, Berns JS. Onconephrology: tumor lysis syndrome. Clin J Am Soc Nephrol. 2012;7:1730-1739. google scholar
- 13. Alakel N, Middeke JM, Schetelig J, Bornhauser M. Prevention and treatment of tumor lysis syndrome and the efficacy and role of rasburicase. Onco Targets Ther. 2017;10:597-605. google scholar
- 14. Wong LM, Cleeve LK, Milner AD, Pitman AG. Malignant ureteral obstruction: outcomes after intervention. Have things changed? J Urol. 2007;178:178-183. google scholar
- 15. Porta C, Cosmai L, Gallieni M, Pedrazzoli P, Malberti F. Renal effects of targeted anticancer therapies. Nat Rev Nephrol. 2015;11:354-370. google scholar
- 16. Skinner R. Strategies to prevent nephrotoxicity of anticancer drugs. Current Opinion Oncol. 1995;7:310-315. google scholar
- 17. Perazella MA, Moeckel GW. Nephrotoxicity from chemotherapeutic agents: clinical manifestations, patho-biology, and prevention/therapy. Semin Nephrol. 2010;30:570-581. google scholar
- 18. Wall SM, Johansen MJ, Molony DA, DuBose TD, Jaffe N, Madden T. Effective clearance of methotrexate using highflux hemodialysis membranes. Am J Kidney Dis. 1996;28:846-854. google scholar
- 19. Widemann BC, Schwartz S, Jayaprakash N, et al. Efficacy of glucarpidase (carboxypeptidase g2) in patients with acute kidney injury after high-dose methotrexate therapy. Pharmacotherapy. 2014;34:427-439. google scholar
- 20. Markowitz GS, Bomback AS, Perazella MA. Drug-induced glomerular disease: direct cellular injury. Clin J Am Soc Nephrol. 2015;10:1291-1299. google scholar
- 21. Schwartz RN, Stover L, Dutcher J. Managing toxicities of high-dose interleukin-2. Oncology. 2002;16:11-20. google scholar
- 22. Perazella MA, Shirali AC. Immune checkpoint inhibitor nephrotoxicity: what do we know and what should we do? Kidney Int. 2020;97:62-74. google scholar
- 23. Saly D, Perazella MA. The adverse effects of cancer immunotherapies. J Onco-Nephrol. 2018;2:56-68. google scholar
- 24. Gurevich F, Perazella MA. Renal effects of anti-angiogenesis therapy: update for the internist. Am J Med. 2009;122:322-328. google scholar
- 25. Perazella MA, Izzedine H. ALK inhibitors. Crizotinib: renal safety evaluation. J Onco-Nephrol. 2017;1:49-56. google scholar
- 26. Schmid M, Abd-El-Barr AE, Gandaglia G, et al. Predictors of 30-day acute kidney injury following radical and partial nephrectomy for renal cell carcinoma. Urol Oncol. 2014;32:1259-1266 google scholar
- 27. Sanders PW, Booker BB. Pathobiology of cast nephropathy from human Bence Jones proteins. J Clin Invest. 1992;89: 630-639. google scholar
- 28. Leung N, Behrens J. Current approach to diagnosis and management of acute renal failure in myeloma patients. Adv Chronic Kidney Dis. 2012;19:297-302. google scholar
- 29. Dimopoulos MA, Roussou M, Gavriatropoulou M, et al. Bortezomibbased triplets are associated with a high probability of dialysis independence and rapid renal recovery in newly diagnosed myeloma patients with severe renal failure or those requiring dialysis. Am J Hematol. 2016;91:499-502. google scholar
- 30. Ludwig H, Adam Z, Hajek R, et al. Light chain-induced acute renal failure can be reversed by bortezomib-doxorubicin-dexamethasone in multiple myeloma: results of a phase II study. J Clin Oncol. 2010;28:4635-4641. google scholar
- 31. Glavey SV, Gertz MA, Dispenzieri A, et al. Long-term outcome of patients with multiple myeloma-related advanced renal failure following auto-SCT. Bone Marrow Transplant. 2013;48: 1543-1547. google scholar
- 32. Bridoux F, Carron PL, Pegourie B, et al; MYRE Study Group. Effect of high-cutoff hemodialysis vs con-ventional hemodialysis on hemodialysis independence among patients with myeloma cast nephropathy: a randomized clinical trial. JAMA. 2017;318:2099-2110. google scholar
- 33. Madore F. Plasmapheresis in cast nephropathy: yes or no? Curr Opin Nephrol Hypertens. 2015;24:177-182. google scholar
- 34. Leung N, Bridoux F, Hutchison CA, et al. Monoclonal gammopathy of renal significance: when MGUS is no longer undetermined or insignificant. Blood. 2012;120:4292-4295. google scholar
- 35. Jhaveri KD, Shah HH, Calderon K, Campenot ES, Radhakrishnan J. Glomerular diseases seen with cancer and chemotherapy: a narrative review. Kidney Int. 2013;84:34-44. google scholar
- 36. Heaf JG, Hansen A, Laier GH. Quantification of cancer risk in glomerulonephritis. BMC Nephrol. 2018;19:27. google scholar
- 37. Beck LH Jr. PLA2R and THSD7A: disparate paths to the same disease? J Am Soc Nephrol. 2017;28:2579-2589. google scholar
- 38. Baldeo C, Ali R, Hritani A, Poenariu A. ANCA-negative pauci-immune crescentic glomerulonephritis linked with nonsmall cell carcinoma of the lung. Case Rep Nephrol Dial. 2015;5:168-172. google scholar
- 39. Mallouk A, Pham PTT, Pham PCT. Concurrent FSGS and Hodgkin’s lymphoma: case report and literature review on the link between nephrotic glomerulopathies and hematological malignancies. Clin Exp Nephrol. 2006;10: 284-289. google scholar
- 40. Au WY, Chan KW, Lui SL, Lam CCK, Kwong YL. Focal segmental glomerulosclerosis and mesangial sclerosis associated with myeloproliferative disorders. Am J Kidney Dis. 1999;34:889-893. google scholar
- 41. Uppal NN, Monga D, Vernace MA, et al. Kidney diseases associated with Waldenstrom macroglobulinemia. Nephrol Dial Transplant. 2019;34:1644-1652. google scholar
- 42. Parikh CR, Yarlagadda SG, Storer B, Sorror M, Storb R, Sandmaier B. Impact of acute kidney injury on long-term mortality after nonmyeloablative hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2008;14:309-315. google scholar
- 43. Jo T, Arai Y, Kondo T, et al. Chronic kidney disease in long-term survivors after allogeneic hematopoie-tic stem cell transplantation: retrospective analysis at a single institute. Biol Blood Marrow Transplant. 2017;23:2159-2165. google scholar
- 44. Kemper MJ, Gungor T, Halter J, Schanz U, Neuhaus TJ. Favorable long-term outcome of nephrotic synd-rome after allogeneic hematopoietic stem cell transplantation. Clin Nephrol. 2007;67:5-1. google scholar
- 45. Hamawi K, De Magalhaes-Silverman M, Bertolatus JA. Outcomes of renal transplantation following bone marrow transplantation. Am J Transplant. 2003;3:301-305. google scholar
- 46. Cohen EP, Krzesinski JM, Launay-Vacher V, Sprangers B. Onco-nephrology: Core Curriculum 2015. Am J Kidney Dis. 2015 Nov;66(5):869-83. doi: 10.1053/j.ajkd.2015.04.042. Epub 2015 Jun 6. google scholar
- 47. Doshi SM, Shah P, Lei X, Lahoti A, Salahudeen AK. Hyponatremia in hospitalized cancer patients and its impact on clinical outcomes. Am J Kidney Dis. 2012;59:222-228. google scholar
- 48. Sorensen JB, Andersen MK, Hansen HH. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in malignant disease. J Intern Med. 1995;238:97-110. google scholar
- 49. Berardi R, Mastroianni C, Lo Russo G, et al. Syndrome of inappropriate anti-diuretic hormo-ne secretion in cancer patients: results of the first multicenter Italian study. Ther Adv Med Oncol. 2019;11:1758835919877725. google scholar
- 50. Refardt J, Imber C,Sailer C, et al. A Randomized Trial of Empaglifozin tı Increase Plasma Sodium Levels in Patients with the Syndrome of Inappropriate Antidiuresis. JASN 31:615-624,2020 google scholar
- 51. Edate S, Albanese A. Management of electrolyte and fluid disorders after brain surgery for pituitary/supra-sellar tumours. Horm Res Paediatr. 2015;83:293-301. google scholar
- 52. Chauhan K, Pattharanitima P, Patel N, et al. Rate of correction of hypernatremia and health outcomes in critically ill patients. Clin J Am Soc Nephrol. 2019;14:656-663. google scholar
- 53. Binstock ML, Mundy GR. Effect of calcitonin and glucocorticoids in combination on the hypercalcemia of malignancy. Ann Intern Med. 1980;93:269-272. google scholar
- 54. Bover J, Bailone L, Lopez-Baez V, Benito S, Ciceri P, Galassi A, Cozzolino M. Osteoporosis, bone mineral density and CKD-MBD: treatment considerations. J Nephrol. 2017;30:677-687. google scholar
- 55. Sturniolo G, Lo Schiavo MG, Tonante A, D’Alia C, Bonanno L. Hypocalcemia and hypoparathyroidism after total thyroidectomy: a clinical biological study and surgical considerations. Int J Surg Investig. 2000;2:99-105 google scholar
- 56. Khan MI, Dellinger RP, Waguespack SG. Electrolyte disturbances in critically ill cancer patients: an endoc-rine perspective. J Intensive Care Med. 2018;33:147-158. google scholar
- 57. Renneboog B, Musch W, Vandemergel X, et al. Mild chronic hyponatremia is associated with falls, unste-adiness, and attention deficits. Am J Med. 2006;119:71 google scholar
- 58. Yoshida T, Taguchi D, Fukuda K, et al. Incidence of hypophosphatemia in advanced cancer patients: a recent report from a single institution. Int J Clin Oncol. 2017;22:244-249. google scholar