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Breast cancer drug raises creatinine without necessarily signaling kidney damage, study finds

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Breast cancer drug raises creatinine without necessarily signaling kidney damage, study finds

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A routine blood test can make a kidney look like it is failing when it is not. A team from Kanazawa University and Shinshu University has shown that this happens often in patients with breast cancer who take abemaciclib, and that a simple baseline measurement can help doctors tell the difference.

Abemaciclib is widely used for hormone receptor–positive breast cancer. It is known to raise serum creatinine, the standard marker used to estimate kidney function. Because creatinine is also pushed out of the body by transporter proteins in the kidney, the rise may reflect blocked transport rather than damaged kidneys. In practice, however, a higher creatinine can still lead to dose reductions, treatment interruptions or extra tests.

The researchers followed 63 patients (62 women and one man) at Shinshu University Hospital. Creatinine rose in 62 of the 63 patients, from a median of 0.63 to 0.85 mg/dL, and the rise stayed stable through 24 weeks of treatment. It fell back after treatment was interrupted. The study is published in the journal Clinical Pharmacology & Therapeutics.

In the 29 patients whose blood had been tested for cystatin C both before and during treatment, cystatin C showed a different pattern. In 28 of them, creatinine and cystatin C moved in opposite directions. Cystatin C is a protein that is not secreted by the same transporters, so it is less affected by the drug.


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