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Clinical and Experimental Nephrology

, Volume 22, Issue 3, pp 727–734 | Cite as

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

  • 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
Original article

Abstract

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.

Keywords

Testicular cancer Cisplatin Chemotherapy Chronic kidney disease Estimated glomerular filtration rate Cystatin C 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee at which the studies were conducted (IRB approval number H24-23) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent as opt-out was obtained from all individual participants included in the study.

Supplementary material

10157_2017_1474_MOESM1_ESM.ppt (126 kb)
Supplementary material 1 (PPT 126 kb)

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Copyright information

© Japanese Society of Nephrology 2017

Authors and Affiliations

  • Daishi Ichioka
    • 1
  • Koji Kawai
    • 1
  • Ken Tanaka
    • 1
  • Ryutaro Ishitsuka
    • 1
  • Takayuki Yoshino
    • 1
  • Tomokazu Kimura
    • 1
  • Shuya Kandori
    • 1
  • Takashi Kawahara
    • 1
  • Takahiro Kojima
    • 1
  • Joichi Usui
    • 2
  • Kunihiro Yamagata
    • 2
  • Jun Miyazaki
    • 1
  • Hiroyuki Nishiyama
    • 1
  1. 1.Department of Urology, Faculty of MedicineUniversity of TsukubaTsukubaJapan
  2. 2.Department of Nephrology, Faculty of MedicineUniversity of TsukubaTsukubaJapan

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