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Routine kidney function tests are underestimating chronic kidney disease in cancer patients, potentially leading to dangerously high chemotherapy doses. A study of 1,200 solid tumor patients found that standard eGFR estimates based on creatinine alone frequently overstated kidney function. Researchers warn this miscalculation means patients may be receiving excess doses of drugs like cisplatin, driving up toxicity risks.
Standard kidney function tests may be giving oncologists a false sense of security when dosing chemotherapy. A prospective study of 1,200 solid tumor patients presented at the American Society of Nephrology's Kidney Week found that estimated GFR (eGFR) based on serum creatinine alone significantly overestimates actual kidney function — meaning many cancer patients are being classified as having better kidney health than they truly do.
The gap is clinically significant: among patients whose measured GFR fell in the 45–59 range (a threshold that typically triggers dose reductions for drugs like cisplatin), nearly three-quarters had creatinine-based eGFR readings above 60 — making them appear ineligible for dose adjustments. Adding cystatin C to the equation improved accuracy somewhat, but concordance with measured GFR remained poor.
By the Numbers:
Why it matters: Inaccurate kidney function estimates can lead to chemotherapy overdosing, putting cancer patients at unnecessary risk of serious toxicity. This study makes a strong case for using measured GFR — not just estimated values — when making dosing decisions in oncology.
