Lung Cancer And Nephrologıc Dıseases

The incidence reported about the malignancy rates in patients with chronic renal insufficiency vary among different series.In a wide series about renal insufficiency in lung cancer, of the 445 lung cancer patients, 14.4% had a serum creatinine (SCR) level 1.25 mg/dL.However, when Cockcroft-Gault and Modification of Diet in Renal Disease formulas were applied, 62.1% and 55.9% respectively had abnormal renal function, according to the KDOQI-KDIGO Kidney Disease Outcomes Quality Initiative (KDOQI) and Kidney Disease: Improving Global Outcomes (KDIGO) definition.Because ~50% of all anticancer drugs are predominantly excreted in urine as an unchanged drug or active metabolite(s), any reduction in renal clearance can result in the accumulation of potentially toxic species and overdosage.Thus, the dosage of chemotherapeutic agents used in these patients with renal insufficiency frequently requires dosage reduction to avoid severe toxicities.The clinical course and survival in patients with lung cancer and chronic kidney disease (CKD) appear to be comparable with those in patients with lung cancer, but without kidney dysfunction.As with all hospitalized patients, those with cancer are at a risk of developing acute kidney injury (AKI) from hypotension, sepsis, or administration of radiocontrast, antifungal, and antibacterial agents.Nephrotoxicity is the most common dose-limiting side effect of cisplatin administration.The primary site for the clearance of cisplatin is the kidney.The most common clinical scenario is the gradual onset of nonoliguric AKI; however, electrolyte wastage is observed, particularly with high dosages of cisplatin.Glomerulonephritis, generally presenting as nephrotic syndrome, is associated with the presence of various types of cancer.The strongest association is with membranous nephropathy and solid tumors (lung, colon, breast, and prostate).