Estimation of Renal Function — What is Appropriate in Cancer Patients?

Barraclough, Lisa H; Field, C.; Wieringa, Gilbert E; Swindell, Ric; Livsey, Jacqueline E; Davidson, Susan E

doi:10.1016/j.clon.2008.09.004

Cited by 25 publications

(26 citation statements)

References 19 publications

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“…However, it should not be neglected that the equation describes only 43% of ECC variability and is prone to large deviations. Former studies are in agreement with our findings, showing the best accuracy of the Wright equation for estimation of renal function in cancer patients [20,21,23]. This suggests that equations perform best when they are applied in patients resembling those included in the development of the equation itself.…”

Section: Estimation Of Renal Functionsupporting

confidence: 93%

“…This is not surprising since it is the only equation estimating creatinine clearance and not GFR. Although a previous study shares our observation [19], other studies, comparing the CG estimates to GFR, measured with isotope, found poorer performance of CG compared to other equations [18,22,23]. The MDRD equation did worse in mimicking ECC in our study.…”

Section: Estimation Of Renal Functioncontrasting

confidence: 64%

“…2. Other studies performed in cancer patients with impaired renal function found either MDRD to be a better predictor than CG and/or Wright equation [18] or similar accuracy was shared between all three equations [23]. However, as calculated values were compared to ClCr determined by ECC, the high contribution of creatinine tubular secretion to the overall CrCl in this range of renal function should be considered.…”

Section: Estimation Of Renal Function In Patients With An Ecc Below 5mentioning

confidence: 96%

“…The MDRD equation did worse in mimicking ECC in our study. Earlier studies demonstrated its poorer performance against Wright equation [23] but better accuracy than CG equation [22].…”

Section: Estimation Of Renal Functionmentioning

confidence: 97%

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Estimation of renal function in lung cancer patients

et al. 2012

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Section: Estimation Of Renal Functionsupporting

confidence: 93%

Section: Estimation Of Renal Functioncontrasting

confidence: 64%

Section: Estimation Of Renal Function In Patients With An Ecc Below 5mentioning

confidence: 96%

“…The MDRD equation did worse in mimicking ECC in our study. Earlier studies demonstrated its poorer performance against Wright equation [23] but better accuracy than CG equation [22].…”

Section: Estimation Of Renal Functionmentioning

confidence: 97%

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Estimation of renal function in lung cancer patients

et al. 2012

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“…There are several reports [8][9][10][11] evaluating the accuracy of various estimating formulas to assess the renal function in cancer patients. It is the common conclusion in these reports that there is no adequate equation to estimate renal function accurately and the measurement by 24hrCcr method may be necessary to evaluate renal function properly.…”

Section: Discussionmentioning

confidence: 99%

Is the eGFR formula adequate for evaluating renal function before chemotherapy in patients with urogenital cancer? A suggestion for clinical application of eGFR formula

et al. 2014

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The eGFR formula is not adequate for the clinical use in cancer chemotherapy. The absolute value of eGFR is not reliable, but clinical use of eGFR as relative value seems to be acceptable. To avoid troublesome 24hrCcr measurement in long-term cancer chemotherapy, eGFR formula can be used for estimating Ccr in combination with the specific inherent 24hrCcr/eGFR ratio, which is obtained from 3 or 4 times of actual 24hrCcr measurements.

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Reliability of estimated glomerular filtration rate in patients treated with platinum containing therapy

Lauritsen

Gundgaard

Mortensen

et al. 2014

Intl Journal of Cancer

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Estimates of glomerular filtration rate (eGFR) are widely used when administering nephrotoxic chemotherapy. No studies performed in oncology patients have shown whether eGFR can safely substitute a measured GFR (mGFR) based on a marker method. We aimed to assess the validity of four major formulas based on PCr (Cockcroft-Gault, MDRD, Wright and CKD-EPI) in comparison to mGFR in an oncology setting. Patients included had disseminated germ cell cancer and received conventional chemotherapy: bleomycin, etoposide and cisplatin. The mGFR of the patients was compared to all estimates with focus on bias (median percentage error), precision (median absolute percentage error) and accuracy (p10 and p30). The precision of carboplatin dosage based on eGFR was calculated. Data on mGFR, eGFR, and PCr were available in 390 patients, with a total of~1,600 measurements. Median PCr and mGFR synchronically decreased after chemotherapy, yielding high bias and low precision of most estimates. Post-chemotherapy, bias ranged from 20.2% (MDRD after four cycles) to 33.8% (CKD-EPI after five cycles1), precision ranged from 11.6% (MDRD after four cycles) to 33.8% (CKD-EPI after five cycles1) and accuracy (p30) ranged from 37.5% (CKD-EPI after five cycles1) to 86.9% (MDRD after four cycles). Although MDRD appeared acceptable after chemotherapy because of high accuracy, this equation underestimated GFR in all other measurements. Before and years after treatment, Cockcroft-Gault and Wright offered best results. Precision of carboplatin dosage was low. In conclusion, bias, precision and accuracy were unacceptable in all equations due to a synchronous decrease of PCr and mGFR during chemotherapy.

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Estimation of Renal Function — What is Appropriate in Cancer Patients?

Cited by 25 publications

References 19 publications

Estimation of renal function in lung cancer patients

Estimation of renal function in lung cancer patients

Is the eGFR formula adequate for evaluating renal function before chemotherapy in patients with urogenital cancer? A suggestion for clinical application of eGFR formula

Reliability of estimated glomerular filtration rate in patients treated with platinum containing therapy

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