[Comparative evaluation of 2 antiemesis tools for the prevention of chemotherapy-induced nausea and vomiting].

Although recent advances in chemotherapy have led to improved quality of life(QOL)and prolonged survival in patients with advanced cancer, treatment is often discontinued because of adverse events associated with chemotherapy, regardless of its efficacy.Nevertheless, chemotherapy has been validated in the United States and United Kingdom and is used worldwide. In Japan, few reports have been published regarding the use of assessment tools including the Multinational Association of Supportive Care in Cancer(MASCC)Antiemesis Tool(MAT)for the evaluation of chemotherapy-induced nausea and vomiting(CINV).We prospectively investigated the utility of the MAT and digestive symptom diary(DSD).In total, 68 patients who underwent highly and moderately emetogenic chemotherapy were included in the efficacy analyses.The improvement in the control of CINV during the delayed phase was significantly different between the DSD and MAT groups(p= 0.0148).The results obtained using the MAT warrant further validation.Meanwhile, the DSD may be used as an information tool by medical staff and patients.

Risk of overestimation of kidney function using GFR-estimating equations in patients with low inulin clearance.

BACKGROUND: Accurate estimation of the glomerular filtration rate (GFR) is very important in clinical practice. Although renal inulin clearance (Cin) is the gold standard for measuring GFR, the procedure for Cin measurement is complicated. Use of GFR-estimating equations has been increasing recently due to their simplicity. The objectives of the present study are to analyze the correlation between Cin and other GFR-estimating parameters and to investigate their clinical usefulness and limitation. METHODS: Seventy-two Japanese patients were enrolled in this study. Cin was measured by the continuous infusion method. Serum creatinine (s-Cr), cystatin C, uric acid (UA), and hemoglobin (Hb) were measured. The Japanese formula of estimated GFR (eGFR) was as follows: eGFR (ml/min/1.73m(2) ) = 194 × s-Cr(-1.094) × Age(-0.287) × 0.739 (if female). The endogenous creatinine clearance test was also performed. RESULTS: Levels of Cin were highly correlated with those of endogenous creatinine clearance (Ccr) (R(2) = 0.7585) and eGFR (R(2) = 0.5659). However, patients with lower Cin showed unexpectedly elevated levels of endogenous Ccr and eGFR. Moreover, the levels of eGFR tended to be unexpectedly increased in patients with low body surface area. CONCLUSION: Although GFR-estimating equations are useful for estimating GFR accurately, they pose a risk of overestimation of kidney function in patients with decreased GFRor a poor physique.