Literature DB >> 25904102

Removal of body surface area normalisation improves raw-measured glomerular filtration rate estimation by the Chronic Kidney Disease Epidemiology Collaboration equation and drug dosing in the obese.

J S C Chew-Harris1,2, P K L Chin3,4, C M Florkowski1,2, P George1,2, Z Endre3,5.   

Abstract

BACKGROUND/AIM: We aimed to compared estimated glomerular filtration rate (eGFR) according to the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI), with (mL/min/1.73 m(2) ) and without body surface area (BSA) normalisation (CKD-EPI_noBSA, mL/min) against measured (99m) Technetium - diethylenepentaacetic acid (Tc-DTPA GFR) (mL/min) in 222 individuals, including 80 with malignancy.
METHODS: BSA was calculated for each individual using the Du Bois equation. The CKD-EPI and CKD-EPI_noBSA equations were compared with measured Tc-DTPA GFR with respect to bias, proportion within 30% of GFR (P30) and root mean square error for predicting levels of GFR, and concordance in relation to carboplatin dosing.
RESULTS: The mean (SD) for BSA and measured GFR for the entire group was 1.99 (0.25) m(2) and 127 (41) mL/min respectively. The P30 for Tc-DTPA GFR was significantly higher with the CKD-EPI_noBSA (80%) than with the CKD-EPI equation (63%, P = 0.0001). In those with body mass index (BMI) > 30 kg/m(2) , the P30 values for the CKD-EPI_noBSA and CKD-EPI were 74% and 42% respectively (P < 0.0001). Carboplatin dosing concordance for the cancer patients using the CKD-EPI and CKD-EPI_noBSA equation was 71% and 56% respectively (P = 0.07). In 78 individuals with BMI > 30 kg/m(2) , concordance in relation to carboplatin dosing using CKD-EPI_noBSA was 65% compared with 26% with the CKD-EPI (P < 0.0001).
CONCLUSION: The CKD-EPI without normalisation (CKD-EPI_noBSA) equation was superior to the CKD-EPI equation in estimating raw-measured Tc-DTPA GFR (mL/min).
© 2015 Royal Australasian College of Physicians.

Entities:  

Keywords:  CKD-EPI; body surface area; creatinine; drug dosing; eGFR; obese

Mesh:

Substances:

Year:  2015        PMID: 25904102     DOI: 10.1111/imj.12791

Source DB:  PubMed          Journal:  Intern Med J        ISSN: 1444-0903            Impact factor:   2.048


  7 in total

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Review 2.  Methods of Estimating Kidney Function for Drug Dosing in Special Populations.

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Journal:  Clin Pharmacokinet       Date:  2018-08       Impact factor: 6.447

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Review 5.  How to adjust drug doses in chronic kidney disease.

Authors:  Maurizio Stefani; Richard F Singer; Darren M Roberts
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6.  Repository Describing the Anatomical, Physiological, and Biological Changes in an Obese Population to Inform Physiologically Based Pharmacokinetic Models.

Authors:  Mattia Berton; Sara Bettonte; Felix Stader; Manuel Battegay; Catia Marzolini
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7.  Novel minimal physiologically-based model for the prediction of passive tubular reabsorption and renal excretion clearance.

Authors:  Daniel Scotcher; Christopher Jones; Amin Rostami-Hodjegan; Aleksandra Galetin
Journal:  Eur J Pharm Sci       Date:  2016-03-28       Impact factor: 4.384

  7 in total

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