Renal impairment after chemotherapy in lung (LC), colorectal (CRC), and breast cancer (BC) patients (pts) from the Henry Ford Health System (HFHS) tumor registry.

Abstract

1590 Background: Renal impairment is a common comorbidity in cancer pts. It can delay excretion and alter metabolism of anticancer drugs leading to further renal toxicity. The objective of this study was to determine the proportion of pts with renal impairment, defined as the presence of proteinuria (PR), acute kidney injury (AKI), or chronic kidney disease (CKD), after chemotherapy (chemo) initiation. Methods: LC, CRC, and BC pts newly diagnosed between 2000 and 2007 (regardless of prior renal status) were identified using the HFHS tumor registry, with follow-up through Mar 2009. AKI was defined based on RIFLE (severity categories only) using lab data within 1 to 7 days after chemo initiation. CKD was defined based on NKF-KDOQI criteria and lab data up to 1 year after chemo initiation. Proteinuria was defined as protein/creatinine >30 mg/g within 3 months after chemo initiation. Descriptive statistics include proportions stratified by renal impairment status (yes, no) at cancer diagnosis. Results: We identified 1,896 LC, 1,088 CRC, 1,611 BC chemo treated pts. Median age for all pts was 66 years. For LC and CRC, 56% and 51% were men, respectively. The proportion of pts with renal impairment after chemo by tumor type was the following: LC (AKI=23.4%; CKD=48.2%; PR=0.4%); CRC (AKI=20.3%; CKD=55.7%; PR=0.1%); BC (AKI=7.8%; CKD=63.9%; PR=0.6%). Pts with pre-existing renal impairment at cancer diagnosis were more likely to have impairment after chemo (Table). Conclusions: In LC, CRC, and BC pts, the proportion of pts with renal impairment after chemo initiation was high. Extent of renal impairment, especially AKI, appears to be associated with tumor type. Older age, as in this HFHS cohort, is associated with higher prevalence of CKD. Renal function should be closely monitored, particularly among pts with pre-existing renal impairment, and preventive measures implemented to minimize further toxicity after treatment.