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Medications-Related Adverse Events and Discordancies in Cystatin C–Based vs Sr Creatinine–Based GFR

Question: What are the implications of discordancies between estimated glomerular filtration rates (eGFR) derived from serum creatinine (eGFRcr) versus those from cystatin C (eGFRcys) for individuals with cancer?

Outcome: Within a study group of 1869 adult cancer patients, those exhibiting an eGFRcys exceeding their eGFRcr by over 30% faced elevated risks of surpassing therapeutic vancomycin levels, experiencing hyperkalemia linked to trimethoprim-sulfamethoxazole, encountering toxic effects of baclofen, exhibiting elevated digoxin levels, and encountering heightened mortality risk within a 30-day span.

Significance: The study's outcomes underscore that patients whose eGFRcys is more than 30% lower than their eGFRcr encounter a higher frequency of medication-related adverse events. This highlights the need for further investigations aimed at enhancing and customizing glomerular filtration rate calculations and medication dosage adjustments in the context of cancer patients.


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