Comparison of glomerular function tests in children with cancer

Abstract

Evaluation of renal function should be performed as part of the follow-up during and after chemotherapy in pediatric cancer patients. The aim of this study was to compare an isotope clearance method [isotope glomerular filtration rate (iGFR)] with alternative methods to determine GFR in such patients. Isotope GFR [(99m)Tc-labeled diethylene triaminopentoacetic acid (DTPA) or (51)Cr-labeled ethylenediaminetetra-acetate (EDTA)] was measured in 36 children (112 studies) and compared with simultaneously measured creatinine clearance (CrCl), serum creatinine (SCr), and cystatin C (CysC) concentrations, as well as the results of Schwartz, Counahan-Barratt, and Cockroft-Gault formulae, using general linear mixed models. Our results showed a significant association between iGFR and CysC concentrations (p < 0.001). No linear relationship was observed between CrCl and iGFR (p = 0.7). As expected, the results of height-based formulae (Counahan-Barratt and Schwartz) had significantly (p = 0.004) better correlation to iGFR than the results of a formula based on weight (Cockroft-Gault) (p = 0.19). Despite significant linear correlation, intraclass correlation coefficients showed poor agreement. Tests of similarity between iGFR estimates showed differences between average values of GFR. Therefore, determination of iGFR remains the method of choice in estimation of GFR in cancer patients. In our study population, assay of serum CysC was the most reliable alternative method to measure glomerular function.

The Role of Tc-99m-DTPA Nuclear Medicine GFR Studies in Pediatric Solid Tumor Patients

“…1,[5][6][7][8][9][10][11][12][13] Similar to these previous studies, the updated Sch correlated poorly with Tc-99m scan result in our cohort. 1,[5][6][7][8][9][10][11][12][13] Similar to these previous studies, the updated Sch correlated poorly with Tc-99m scan result in our cohort.…”

Evaluation of the Renal Function Using Cystatin C Level in the Patients Receiving Cisplatin-Based Chemotherapy

“…Some studies have reported that cystatin C can be used as an appropriate marker in monitoring the renal function, especially in children. 16,18,23 In fact, accurate and simple GFR measurement is crucial in elderly cancer patients. The results from the studies regarding adults are inconsistent.…”

“…[12][13][14][15] Some studies have demonstrated that cystatin C was a better indicator in determining the renal function compared to creatinine in the patients receiving cisplatinbased chemotherapy. 8,[16][17][18] Furthermore, it was reported that cystatin C was found in higher concentrations in the tissues and body fluids of breast and prostate cancer patients and this was correlated with the aggressive form of the cancer. 19,20 The aim of our study was to evaluate the correlation of the serum cystatin C levels with the serum creatinine levels and GFR calculated by CockcroftGault and MDRD formulations in the patients who received cisplatin-based chemotherapy.…”

Correlation of Cystatin-C and radionuclidic measurement method of glomerular filtration rate in patients with lung cancer receiving cisplatin treatment

“…In addition, they showed that Cystatin-C values were important alternative to the measurement of GFR values. 29 In a study made in patients with varying degrees of renal failure and healthy volunteers, Trimarchi and his colleagues showed that, in patients whom GFR level is lower than 60 mL/minute, multiple blood sampling method showed the best correlation with Cystatin-C based Hoek formula. (r ¼ 0.82, P50.001).…”