The Chronic Kidney Disease Epidemiology Collaboration cystatin C (CKD‐EPI‐CysC) equation has an independent prognostic value for overall survival in newly diagnosed patients with symptomatic multiple myeloma; is it time to change from MDRD to CKD‐EPI‐CysC equations?

Abstract

Our results suggest that equations based on CysC reveal higher number of MM patients with RI compared with equations based only in sCr. Furthermore, the CKD-EPI-CysC formula independently predicted for survival. Based on these data, we suggest that CKD-EPI equations based on CysC should substitute MDRD, as it has been suggested for patients with several other renal disorders.

Prognostic Value of Renal Dysfunction Indicators in Normotensive Patients With Acute Pulmonary Embolism

“…Similar findings have already been reported in patients with multiple myeloma, 26 but the advanced age of the patients in this study (>70) may be the reason for this discrepancy. 27…”

Cystatin C as a predictor factor in patients with renal cell carcinoma treated by everolimus

“…It is transcribed at a relatively constant level, is expressed in all nucleated cells and has multiple biological functions including control of extracellular proteolysis, modulation of the immune system and exertion of antibacterial and antiviral activities [10]. It is a low molecular weight secretory protein that inactivates members of the cathepsin family of cysteine proteases.…”

“…Some reports indicate that CysC levels may be increased in oncological patients, leading to biased results in GFR estimation. Some researchers observed a prognostic role of elevated levels of CysC in lung cancer [12], myeloma multiplex [10] and colorectal cancer [13].…”

European Myeloma Network Guidelines for the Management of Multiple Myeloma-related Complications

“…46,55,56 The IMWG has recommended the use of the MDRD equation for the estimation of GFR in MM patients, 56 and the Kidney Disease Improving Global Outcomes (KDIGO) classification for the classification of RI in MM patients. 57 Recently, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas, with or without cystatin C, has been used for the accurate detection of manifest RI, 58,59 and especially the CKD-EPI-cystatin C equation seems to provide an independent prognostic value, which needs to be further elucidated and formally compared to currently used equations both in newly diagnosed and relapsed patients. 58 The improved prognostic ability and more sensible detection of RI by the CDK-EPI compared to the MDRD estimation therefore enlarges the arsenal of eGFR formulas and should lead to a broader use of CKD-EPI formulas for the estimation of GFR in patients with myeloma.…”