Renal Insufficiency in Cancer Patients and Associated Demographic, Clinical and Treatment Characteristics at Kenyatta National Hospital, Nairobi, Kenya
Abstract
Renal insufficiency is sub-optimal kidney function, affecting approximately 10% of the world population. In sub-Saharan Africa, it is approximated at 14% of the population whereas the kidney disease burden in Kenya is estimated to be at 4%. Studies show that at least 27.1% of cancer patients are suffering from renal insufficiency and need some chemotherapeutic drug adjustment. The objective of this study was to establish the prevalence of renal insufficiency and the associated clinical, demographic and treatment factors among cancer patients at KNH. A cross-sectional study where data was collected using a structured interviewer-administered questionnaire and hospital records. Systematic random sampling without replacement was used to select eligible 330 participants (patients) from Oncology wards and clinics at KNH. The information from the questionnaires was entered into a computer, cleaned, coded and loaded into R version 4.1.2 statistical software for analysis. Calculation of estimated GFR was done by CKD-Epi in micromole/l using a medical calculator to diagnose renal insufficiency and classify accordingly. The data was analyzed using both descriptive and bivariate/ multivariate regression analysis. All p-values were two-sided and the results were considered statistically significant at p < 0.05. A total of 56.1% were females and others were male. Of the 330 study participants, 42.7% were aged between 41-60, 41.5% above 60 years and the rest below 41 years. The prevalence of renal insufficiency was 38% (95% CI 33, 44%). Age above 60 years and the use of taxanes were significantly associated with renal insufficiency before and after adjustment (p-values <0.05). In conclusion, the prevalence of renal insufficiency among patients with cancer was high in this study of which the majority had stage 2 renal failures. Patients aged above 60 years had significantly higher odds of renal insufficiency while patients on taxanes had significantly lower odds of renal insufficiency
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Aapro, M., & Launay-Vacher, V. (2012). Importance of monitoring renal function in patients with cancer. Cancer Treatment Reviews, 38(3), 235– 240. https://doi.org/10.1016/j.ctrv.2011.05.001
Bednarek, A., Mykała-Cieśla, J., Pogoda, K., Jagiełło-Gruszfeld, A., Kunkiel, M., Winder, M., & Chudek, J. (2020). Limitations of Systemic Oncological Therapy in Breast Cancer Patients with Chronic Kidney Disease. Journal of Oncology, 2020, 7267083. https://doi.org/10.1155/2020/7267083
Bursac, Z., Gauss, C.H., Williams, D.K. et al. Purposeful selection of variables in logistic regression. Source Code Biol Med 3, 17 (2008). https://doi.org/10.1186/1751-0473-3-17.
Dogan E, Izmirli M, Ceylan K, Erkoc R, Sayarlioglu H, Begenik H, Alici S (2015) Incidence of renal insufficiency in cancer patients. Adv Ther 22: 357–362
Ephraim, R. K. D., Mantey, R., Atombo, S., Sakyi, S. A., Fondjo, L. A., Tashie, W., … Amankwaa, B. (2018). Chronic kidney disease in type 2 diabetes mellitus patients: Comparison of KDIGO and KDOQI guidelines. Alexandria Journal of Medicine, 54(4), 445–449. https://doi.org/10.1016/j.ajme.2018.07.003
Habas, E., Akbar, R., Farfar, K., Arrayes, N., Habas, A., Rayani, A., Alfitori, G., Habas, E., Magassabi, Y., Ghazouani, H., Aladab, A., & Elzouki, A.-N. (2023). Malignancy diseases and kidneys: A nephrologist prospect and updated review. Medicine, 102(15), e33505. https://doi.org/10.1097/MD.0000000000033505
Hertzog MA. Considerations in determining sample size for pilot studies. Res Nurs Health. 2008 Apr;31(2):180-91. doi: 10.1002/nur.20247. PMID: 18183564.
Israel, G.D. (1992) Determining Sample Size. University of Florida Cooperative Extension Service, Institute of Food and Agriculture Sciences, EDIS, Florida.
Janus, N., Launay-Vacher, V., Byloos, E., Machiels, J. P., Duck, L., Kerger, J., Wynendaele, W., Canon, J. L., Lybaert, W., Nortier, J., Deray, G., & Wildiers, H. (2010). Cancer and renal insufficiency results of the BIRMA study. British journal of cancer, 103(12), 1815– 1821. https://doi.org/10.1038/sj.bjc.6605979
Janus, N., Launay-vacher, V., Byloos, E., Machiels, J.-P., Duck, L., Kerger, J., Wynendaele, W., Canon, J.-L., Lybaert, W., Nortier, J., Deray, G., & Wildiers, H. (2015). Cancer and renal insufficiency results of the BIRMA study. British Journal of Cancer, 103(12), 1815–1821. https://doi.org/10.1038/sj.bjc.6605979
Kidney Disease Improving Global Outcomes (KDIGO). KDIGO clinical practice guideline for acute kidney injury. kdigo.org/wpcontent/uploads/2016/10/KDIGO-2012-AKI-Guide line-Engli sh.pdf. Accessed 23 Mar 2020
Lameire, N. (2013). Nephrotoxicity of recent anti-cancer agents. Clinical Kidney Journal, 7(1), 11. https://doi.org/10.1093/ckj/sft135
Launay-Vacher V, Oudard S, Janus N, Gligorov J, Pourrat X, Rixe O, Morere JF, Beuzeboc P, Deray G (2007) Prevalence of renal insufficiency in cancer patients and implications for anticancer drug management: the renal insufficiency and anticancer medications (IRMA) study. Cancer 110: 1376–1384
Launay-Vacher, V. (2010). Epidemiology of Chronic Kidney Disease in Cancer Patients: Lessons From the IRMA Study Group. Seminars in Nephrology, 30(6), 548–556. https://doi.org/10.1016/j.semnephrol.2010.09.003
Launay-Vacher, V., Janus, N., & Deray, G. (2016). Renal insufficiency and cancer treatments. ESMO Open, 1(4), e000091. https://doi.org/10.1136/esmoopen-2016-000091
Manyau, P. M. C., Mabeka, M., Mudzviti, T., Kadzatsa, W., & Nyamhunga, A. (2021). Renal function impairment in cervical cancer patients treated with cisplatin-based chemoradiation: A review of medical records in a Zimbabwean outpatient department. PLOS ONE, 16(2), e0245383. https://doi.org/10.1371/journal.pone.0245383
Pontes, L. de B., Antunes, Y. P. P. V., Bugano, D. D. G., Karnakis, T., Giglio, A. del, & Kaliks, R. A. (2014). Prevalence of renal insufficiency in elderly cancer patients in a tertiary cancer center. Einstein (São Paulo), 12, 300–303. https://doi.org/10.1590/S1679-45082014AO3003
Puri, P., Fadia, M., Puri, P., Jiang, S., & Z, W. (2020). Letrozole-Induced Acute Interstitial Nephritis. Journal of Clinical and Medical Case Reports, 1–3. https://doi.org/10.31487/j.JCMCR.2020.01.06
Rajabu, H. N., Hinderaker, S. G., Mnandi, P., & Mutagonda, R. F. (2024). Prevalence of renal insufficiency and factors associated among selected cancer patients on chemotherapy at Ocean Road Cancer Institute in Tanzania: A cross-sectional study. BMC Cancer, 24(1), 763. https://doi.org/10.1186/s12885-024-12419-y
Silva, V. T. da C. e, Costalonga, E. C., Coelho, F. O., Caires, R. A., & Burdmann, E. A. (2018). Assessment of Kidney Function in Patients With Cancer. Advances in Chronic Kidney Disease, 25(1), 49– 56. https://doi.org/10.1053/j.ackd.2017.10.010
Strati, P., Chaffee, K. G., Achenbach, S. J., Slager, S. L., Leung, N., Call, T. G., Ding, W., Parikh, S. A., Kay, N. E., & Shanafelt, T. D. (2017). Renal insufficiency is an independent prognostic factor in patients with chronic lymphocytic leukemia. Haematologica, 102(1), e22. https://doi.org/10.3324/haematol.2016.150706
Webster AC, Evi V Nagler, Rachael L Morton, Philip Masson, Chronic Kidney Disease, The Lancet, Volume 389, Issue 10075, 2017, Pages 1238- 1252, ISSN 0140- 6736, https://doi.org/10.1016/S0140-6736(16)32064-5.
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