用于治疗恶性肿瘤的许多化疗药物都要通过肾脏清除。因此，准确了解肾功能对于确保正确使用药物剂量、最大限度地发挥药效并最小化毒性至关重要，这些药物通常具有较窄的治疗指数。更使这个问题更引人注目的是，患有癌症的患者常常会遇到肾功能受损的情况，如以肾小球滤过率（GFR）评估的情况。最近的数据和专家指南建议使用慢性肾病 - 流行病学合作公式来指导肾功能评估，除非需要临床直接测量GFR。关于肾功能测量的争议包括在该公式中使用种族、基于体表面积指数和根据慢性肾病阶段还是预估GFR离散值的药物剂量。开发准确的实时GFR测量方法可能有望实现更准确的这些重要药物的剂量控制。Copyright © 2023 Elsevier Inc. All rights reserved.

Many chemotherapeutic drugs used to treat malignancies undergo renal clearance. Thus, accurate knowledge of kidney function is critical to ensure proper dosing, maximize efficacy, and minimize toxicity of drugs that often have a narrow therapeutic index. Making this issue more salient is the fact that impaired kidney function, as assessed by glomerular filtration rate (GFR), is encountered commonly in patients with cancer. Recent data and expert guidelines recommend the use of the Chronic Kidney Disease-Epidemiology Collaboration equation to guide the assessment of kidney function, except when directly measured GFR is clinically necessary. Controversies regarding the measurement of kidney function include the use of race in this equation, indexing to body surface area, and dosing of medications based on stages of chronic kidney disease versus more discrete values of estimated GFR. The development of accurate, real-time GFR measures may hold great promise in allowing for more accurate dosing of these important drugs.Copyright © 2023 Elsevier Inc. All rights reserved.