A New Equation for Estimating Glomerular Filtration Rate in Cancer Patients

Abstract

Background: The accuracy of the Cockcroft-Gault (CG) equation, the Modification of Diet in Renal Disease (MDRD) equation and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation in cancer patients was tested. An equation for estimating glomerular filtration rate (GFR) was created that was adapted to cancer patients. Methods: Data from 641 oncology patients referred for ⁵¹Cr-EDTA measurements were included. Factors that may affect GFR, i.e. gender, hypertension, diabetes, non-steroid anti-inflammatory drugs (NSAID), exposure to chemotherapy, age, weight, height, BMI, body surface area and creatinine value were correlated to ⁵¹Cr-EDTA-measured GFR. The significant factors were then included in a multiple regression analysis correlated to the measured GFR (mGFR). Results: The equation of log₁₀ (GFR; ml/min/1.73 m²) = 2.36-0.33*log₁₀ (age) - 0.78*log₁₀ (creatinine) + 0.87*log₁₀ (weight) - 0.03*NSAID*log₁₀ (creatinine) + gender (1 = female, 0 = male)*(0.05*NSAID - 0.003*BMI) was generated. Expressed as a mean (standard deviation) of mGFR <60 ml/min/1.73 m², this equation, the ‘New Equation', overestimated GFR by 26 (33)%, while CG, MDRD and CKD-EPI overestimated GFR by 26 (40)%, 32 (42)% and 48 (47)%, respectively. For mGFR ≥60 ml/min/1.73 m², the New Equation underestimated GFR by only 3 (16)%, while CG, MDRD and CKD-EPI overestimated GFR by 12 (25)%, 10 (26)% and 5 (23)%, respectively. Conclusion: This study describes a novel equation with a higher accuracy than other commonly used GFR equations for estimating GFR in cancer patients.

Clinical questions and good practice statements of clinical practice guidelines for management of kidney injury during anticancer drug therapy 2022

“…The two reports by Funakoshi et al were the only publications that studied Japanese patients with cancer and GFR estimation formulae developed by the JSN [9, 10], while most of other papers evaluated CKD-EPI, Modification of Diet in Renal Disease (MDRD), and Cockcroft-Gault developed in the United States. Therefore, a meta-analysis was conducted on nine papers evaluating the accuracy of the CKD-EPI formula, which is currently the most widely used worldwide [10][11][12][13][14][15][16][17][18]. The collective estimate was 81% (95% confidence interval (CI): 71-91%).…”

Serum Cystatin C as a Potential Marker for Glomerular Filtration Rate in Patients with Cholangiocarcinoma

“…Creatinine is considered as not a sensitive marker to detect mild and medium decrease of renal function, also known as ‘creatinine blind area’ so that the over estimation of GFR usually occurs and make lots of under diagnosed cases 25 . A study by Daniel Giglio in 2014 showed that CKD-EPIscr equation was precise in cancer patients with GFR ≥60 ml/min/1.73 m 2 26 .…”

Serum Phosphorus, Serum Bicarbonate, and Renal Function in Relation to Liver CYP1A2 Activity

“…Estimated glomerular filtration rate (eGFR) was estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-Epi equation model using serum creatinine, sex, age, and race). Information regarding this equation can be found elsewhere [ 30 ]. We categorized eGFR into the following groups: >90, 60 to 90, and <60 mL/min/1.73 m 2 .…”