論文

査読有り
2018年6月

Possible risk of overestimation of renal function using cystatin C-based eGFR in testicular cancer survivors treated with cisplatin-based chemotherapy.

Clinical and experimental nephrology
  • Daishi Ichioka
  • ,
  • Koji Kawai
  • ,
  • Ken Tanaka
  • ,
  • Ryutaro Ishitsuka
  • ,
  • Takayuki Yoshino
  • ,
  • Tomokazu Kimura
  • ,
  • Shuya Kandori
  • ,
  • Takashi Kawahara
  • ,
  • Takahiro Kojima
  • ,
  • Joichi Usui
  • ,
  • Kunihiro Yamagata
  • ,
  • Jun Miyazaki
  • ,
  • Hiroyuki Nishiyama

22
3
開始ページ
727
終了ページ
734
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s10157-017-1474-x
出版者・発行元
Springer Tokyo

BACKGROUND: Chronic kidney disease (CKD) is a major long-term morbidity of testicular cancer (TC) survivors cured by cisplatin-based chemotherapy. We conducted the present study to elucidate the usefulness of cystatin-based estimated glomerular filtration rates (eGFRcys) for diagnosis of CKD compared to creatinine-based eGFR (eGFRcreat) in those patients. METHODS: eGFRcys and eGFRcreat were measured in 53 TC survivors. The 24-h creatinine clearance (CrCl) was measured in 12 TC survivors and 17 CKD patients with medical disease; all of them had eGFRcreat <60 m/min/1.73 m2. Also, urinary beta2-microglobulin and albumin concentrations in spot urine specimens were measured. RESULTS: The mean eGFRcreat was significantly lower than eGFRcys, at 67.9 and 95.2 ml/min/1.73 m2, respectively (p < 0.05). The prevalence of stage 3-5 CKD differed by GFR estimation methods. It was 47.2% with eGFRcreat and only 7.5% with eGFRcys. There were 21 patients with eGFRcreat <60 ml/min/1.73 m2 and eGFRcys ≥60 ml/min/1.73 m2. In all 12 TC survivors, the eGFRcys values were higher than both eGFRcreat and GFR (24-h CrCl). In contrast, no difference was observed among eGFR values in the 17 patients with CKD due to medical disease. Ten of 21 patients with eGFRcreat <60 ml/min/1.73 m2 and eGFRcys ≥60 ml/min/1.73 m2 showed significant beta2-microglobulinuria: a higher prevalence than that in patients with both eGFRs ≥60 ml/min/1.73 m2. Also, the incidence of microalbuminuria tended to be high in those patients. CONCLUSIONS: The present study suggests that eGFRcys may overestimate renal function in TC survivors cured by cisplatin-based chemotherapy.

リンク情報
DOI
https://doi.org/10.1007/s10157-017-1474-x
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/28948387

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