Comparing glomerular filtration rate equations and the impact of different creatinine assays on the assessment of renal function in cancer patients

2019 ◽  
Vol 56 (2) ◽  
pp. 266-274 ◽  
Author(s):  
Ashley E Garner ◽  
Mark C Barnfield ◽  
Michael L Waller ◽  
Geoff D Hall ◽  
Mike P Bosomworth
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Cancer Patients ◽  
Filtration Rate ◽  
Rate Equations ◽  
Disease Epidemiology ◽  
Estimate Glomerular Filtration Rate ◽  
The Impact ◽  
Better Than

Background Equations to estimate glomerular filtration rate based on serum creatinine are commonly used in cancer patients to assess renal function. However, there is uncertainty regarding which equation is most appropriate for this population and the impact of different creatinine assays. Methods Measured isotopic glomerular filtration rate results from 120 oncology patients were used to evaluate and compare all four versions of the Wright equation, Cockcroft and Gault, Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration and the Janowitz and Williams formula; using eight different creatinine assays (five Jaffe, three enzymatic). Results The enzymatic version of the Wright equation without creatine kinase performed better than the other versions for all eight creatinine assays. However, MDRD and Janowitz and Williams gave the best overall performance in this patient population. Performance was highly dependent on the creatinine assay used, for example, the percentage of results within 30% of the isotopic glomerular filtration rate (P30) ranged from 90.8% to 60.8% for MDRD. Conclusion The performance of any equation to estimate glomerular filtration rate is highly dependent on the creatinine assay used. Oncology units should assess the performance of glomerular filtration rate equations using their laboratory creatinine assay to determine whether they can be used safely and effectively in cancer patients.

scholarly journals Clinical Implications of the New Equation to Estimate Glomerular Filtration Rate

Nephron ◽  
2021 ◽  
pp. 1-5
Author(s):  
Davide Giavarina ◽  
Faeq Husain-Syed ◽  
Claudio Ronco
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Significant Proportion ◽  
Disease Epidemiology ◽  
Estimation Equations ◽  
Estimate Glomerular Filtration Rate ◽  
Gfr Estimation ◽  
New Equation ◽  
The Impact

Recently, a new full-age spectrum equation was proposed by the European Kidney Function Consortium (EKFC) to overcome the difficulty of using multiple glomerular filtration rate (GFR) estimation equations and problems of implausible changes in GFR during the transition from adolescence to adulthood and address GFR overestimation in young adults and in the older adults. To verify the impact on patient classifications, we applied the new equation to data of 38,188 adult patients, comparing GFR estimation using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and EKFC equations. As expected, our data indicate that a significant proportion of patients will be reclassified downward by the EKFC compared to the CKD-EPI equation with a particular reference between CKD stages 1–2 and 2–3 and age categories of 18–30 and ≥61 years, respectively. Clinicians should be aware that any replacement for the EKFC equation will entail a period of different results in estimated GFR during the transition from the previous to the new equation.

scholarly journals Performance of CKD-EPI equation to estimate glomerular filtration rate as compared to MDRD equation in South Brazilian individuals in each stage of renal function

2014 ◽  
Vol 52 (12) ◽  
Author(s):  
Francisco Veríssimo Veronese ◽  
Eduardo C. Gomes ◽  
Joana Chanan ◽  
Maicon A. Carraro ◽  
Eduardo G. Camargo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Disease Epidemiology ◽  
Mdrd Equation ◽  
Estimate Glomerular Filtration Rate

AbstractThe Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation seems to correct the overdiagnosis of chronic kidney disease (CKD) provided by Modification of Diet in Renal Disease (MDRD) equation. However, this point has not been tested in some ethnic groups. This study investigated the performance of MDRD and CKD-EPI equations in South Brazilian individuals.This cross-sectional study included 354 individuals including healthy volunteers, diabetic and non-diabetic individuals with or without CKD. Glomerular filtration rate (GFR) was measured by theIn the group as a whole,CKD-EPI reduces GFR underestimation in individuals with GFRs >60, but still presents a quite low accuracy at this GFR range. Moreover, it tends to overestimate GFR in subjects with GFRs <60 mL/min/1.73 m

scholarly journals Evaluation of Serological Indicators and Glomerular Filtration Rate Equations in Chinese Cancer Patients

2017 ◽  
Vol 23 ◽  
pp. 2949-2960 ◽  
Author(s):  
Yingna Tong ◽  
Xiaobin Liu ◽  
Mingxiu Guan ◽  
Meng Wang ◽  
Lufang Zhang ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Cancer Patients ◽  
Filtration Rate ◽  
Rate Equations ◽  
Chinese Cancer Patients

EXPRESS: Drug dosing using estimated Glomerular Filtration Rate: Misclassification due to metamizole interference in a creatinine assay

2021 ◽  
pp. 000456322110200
Author(s):  
Luana Bojko ◽  
Gustavo de Paula Ripka ◽  
Laura Mattana Dionísio ◽  
Celso Luiz Borges ◽  
Danielle Cristyane Kalva Borato ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Drug Dosing ◽  
Significant Difference ◽  
The Impact ◽  
Creatinine Measurement

The estimated glomerular filtration rate is a rather important measurement for patients under intensive care, since they often receive several drugs, and impaired renal function may result in misleading dosing. The estimated glomerular filtration is derived from mathematical models using serum creatinine, a measurement that suffers interference of some drugs, such as metamizole. The study intented to evaluate the impact on patient stratification for dose adjustment of two antimicrobials (meropenem and vancomycin) caused by metamizole interference in creatinine measurement by dry chemistry. A cross-sectional study was conducted with a group of 108 hospitalized patients under metamizole prescriptions at fixed intervals. Serum creatinine levels were determined by enzymatic dry chemistry and Jaffé assays and the estimated glomerular filtration rate was calculated through the CKD-EPI equation. Patients were stratified in groups according to their estimated glomerular filtration rate for drug dosing of vancomycin and meropenem. As expected, creatinine values were significantly lower in measurements performed by the dry chemistry method in comparison to Jaffé assay (p<0.0001) when patients are under metamizole treatment. A significant bias (-40.3%) was observed between those two methods, leading to a significant difference (p<0.0001) in patient classification according to renal function using the CKD-EPI equation for dosing adjustment. Thus, during the validity of metamizole treatment, the stratification for drug dosing by the estimated glomerular filtration rate is not reliable if the creatinine measurement is done through dry chemistry. Clinical and laboratory staff must be aware of these limitations and cooperate to optimize pharmacotherapy.

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