Agreement and Precision Analyses of Various Estimated Glomerular Filtration Rate Formulae in Cancer Patients

Abstract

The accuracy of the estimated glomerular filtration rate (eGFR) in cancer patients is very important for dose adjustments of anti-malignancy drugs to reduce toxicities and enhance therapeutic outcomes. Therefore, the performance of eGFR equations, including their bias, precision, and accuracy, was explored in patients with varying stages of chronic kidney disease (CKD) who needed anti-cancer drugs. The reference glomerular filtration rate (GFR) was assessed by the 99mTc-diethylene triamine penta-acetic acid (99mTc-DTPA) plasma clearance method in 320 patients and compared with the GFRs estimated by i) the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, ii) the unadjusted for body surface area (BSA) CKD-EPI equation, iii) the re-expressed Modification of Diet in Renal Disease (MDRD) study equation with the Thai racial factor, iv) the Thai eGFR equation, developed in CKD patients, v) the 2012 CKD-EPI creatinine-cystatin C, vi) the Cockcroft-Gault formula, and vii) the Janowitz and Williams equations for cancer patients. The mean reference GFR was 60.5 ± 33.4 mL/min/1.73 m2. The bias (mean error) values for the estimated GFR from the CKD-EPI equation, BSA-unadjusted CKD-EPI equation, re-expressed MDRD study equation with the Thai racial factor, and Thai eGFR, 2012 CKD-EPI creatinine-cystatin-C, Cockcroft-Gault, and Janowitz and Williams equations were −2.68, 1.06, −7.70, −8.73, 13.37, 1.43, and 2.03 mL/min, respectively, the precision (standard deviation of bias) values were 6.89, 6.07, 14.02, 11.54, 20.85, 10.58, and 8.74 mL/min, respectively, and the accuracy (root-mean square error) values were 7.38, 6.15, 15.97, 14.16, 24.74, 10.66, and 8.96 mL/min, respectively. In conclusion, the estimated GFR from the BSA-unadjusted CKD-EPI equation demonstrated the least bias along with the highest precision and accuracy. Further studies on the outcomes of anti-cancer drug dose adjustments using this equation versus the current standard equation will be valuable.

Decreased Preoperative Estimated Glomerular Filtration Rate Was Related With Poor Prognosis of NSCLC Patients

“…Cox regression analysis showed eGFR was an independent prognostic factor of both OS and DFS. Studies found new equation to analyze eGFR in cancer patients 9,13,14 which needs further validation studies to support.…”

“…Cox regression analysis showed eGFR was an independent prognostic factor of both OS and DFS. Studies found new equation to analyze eGFR in cancer patients 9 , 13 , 14 which needs further validation studies to support. In that we used the 2009 CKD-EPI, which is recommended by The National Kidney Foundation, to estimate GFR level.…”

“…eGFR is fundamental to several aspects of cancer therapy, including decision in surgical treatment, perioperative management, chemotherapy dose adjustment, and preparation of long-term care. 9 …”

Association Between Serum Calcium and the Prevalence of Hypertension Among US Adults

“…Body mass index (BMI) was calculated by dividing weight in kilograms by the square of their height in meters (kg/m 2 ). Estimated glomerular filtration rate was estimated using the Modification of Diet in Renal Disease (MDRD) equation incorporating age, sex, race, and serum creatinine in the equation ( 22 ).…”

Repurposing of High-Dose Erythropoietin as a Potential Drug Attenuates Sepsis in Preconditioning Renal Injury

“…In case of more than one modality performed during the study period, only the most sophisticated one (continuous renal replacement therapy > sustained low-efficiency dialysis > intermittent hemodialysis) has been reported. APACHE, Acute Physiology and Chronic Health Evaluation (APACHE II) score; CERA, continuous erythropoietin receptor activator; eGFR, estimated glomerular filtration rate calculated by the CKD-EPI equation[26]; EPO, erythropoietin; ICU, intensive care unit; IQR, interquartile ranges. To convert values for iron to micromoles per liter, multiply by 0.179.…”