Standard kidney function tests underestimate chronic kidney disease in people with cancer
· Medical Xpressby American Society of Nephrology
edited by Gaby Clark, reviewed by Andrew Zinin
Gaby Clark
Scientific Editor
Meet our editorial team
Behind our editorial process
Andrew Zinin
Chief Editor
Meet our editorial team
Behind our editorial process Editors' notes
This article has been reviewed according to Science X's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility:
fact-checked
trusted source
proofread
The GIST Add to Preferred Sources
New research indicates that commonly used measures of kidney function underestimate the prevalence of chronic kidney disease (CKD) in patients with cancer. The findings will be presented at ASN Kidney Week 2026, Oct. 22–25.
In 1,200 adults with solid tumors, investigators compared measured glomerular filtration rate (mGFR), which directly measures kidney filtration rate using a specialized clearance marker, with commonly used estimated GFR (eGFR) values based on the blood proteins cystatin C and creatinine.
CKD prevalence rates based on mGFR, eGFR based on creatinine and eGFR based on both creatinine and cystatin C were 18.9%, 10.2% and 15.7%, respectively. Among those with mGFR of 45–59 ml/min/1.73 m² (indicating mild to moderate CKD), 72.1% had creatinine-based eGFR >60, suggesting that they had normal kidney function. Among those with mGFR <45 (indicating more advanced CKD), 52.5% had creatinine-based eGFR >45. Adding cystatin C to creatinine improved GFR discrepancy, but concordance remained poor.
These thresholds are especially important for decisions about drug eligibility and dose adjustments, as drug clearance rates often drop as kidney function declines. "The results suggest that errors in GFR estimation may contribute to excessive toxicity in patients with cancer receiving anticancer therapy," said corresponding author Veronica Torres Costa e Silva, M.D., Ph.D., of the University of São Paulo Medical School, in Brazil.
"I'll give the example of cisplatin. Most recommendations state that patients with GFR of 45–60 ml/min/1.73 m² should have a dose reduction of 25%–50%, and those with GFR below 45 ml/min/1.73 m² should not be considered eligible. This means that our patients are receiving exceedingly higher doses and having a higher frequency of toxicity because we are not capable of accurately assessing GFR and making accurate dose adjustments."
Key medical concepts
Clinical categories
OncologyNephrologyClinical pharmacology Provided by American Society of Nephrology Who's behind this story?
Gaby Clark
MA in English, copy editor since 2021 with experience in higher education and health content. Dedicated to trustworthy science news. Full profile →
Andrew Zinin
Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →
Citation: Standard kidney function tests underestimate chronic kidney disease in people with cancer (2026, October 23) retrieved 24 October 2026 from https://medicalxpress.com/news/2026-10-standard-kidney-function-underestimate-chronic.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.