Background and Objective Monitoring renal function is critical in treating pediatric patients, especially when dosing nephrotoxic agents. We evaluated the validity of the bedside Schwartz and Brandt equations in pediatric oncology patients, and developed new equations for estimated glomerular filtration rate (GFR) in these patients. Methods A retrospective analysis was conducted on patients comparing the estimated GFR using the bedside Schwartz and Brandt equations to measured GFR (mGFR) from 99mTechnetium-DPTA (99mTc-DTPA) between January 2007 and August 2013. An improved equation to estimate GFR was developed, simplified, and externally validated in a cohort of patients studied from September 2013 to June 2015. Carboplatin doses calculated from 99mTc-DTPA were compared to doses calculated by GFR estimating equations. Results Overall, the bedside Schwartz and Brandt equations did not precisely or accurately predict mGFR in our pediatric oncology patient population. Using a subset of the data, we developed a 5-covariate equation, which included the covariates of height, serum creatinine, age, BUN, and gender, and a simplified version (2-covariates), which only contained height and serum creatinine. These equations were used to estimate GFR in 2036 studies, resulting in precise and accurate predictors of the mGFR values. The equations were validated in an external cohort of 570 studies; both new equations were more accurate in calculating carboplatin doses than either the bedside Schwartz or Brandt equation. Conclusions Two new equations were developed to estimate GFR in pediatric oncology patients, both of which did a better job at estimating mGFR than published equations.

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