Ashley E Garner1, Mark C Barnfield2, Michael L Waller2, Geoff D Hall3, Mike P Bosomworth1. 1. 1 Department of Blood Sciences, Leeds General Infirmary, Old Medical School, Leeds, UK. 2. 2 The Department of Medical Physics & Engineering, St. James's University Hospital, Leeds, UK. 3. 3 Cancer Research UK Clinical Cancer Centre in Leeds, St. James's University Hospital, Leeds, UK.
Abstract
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.
BACKGROUND: Equations to estimate glomerular filtration rate based on serum creatinine are commonly used in cancerpatients 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 cancerpatients.
Authors: Edward H Williams; Thomas R Flint; Claire M Connell; Daniel Giglio; Hassal Lee; Taehoon Ha; Eva Gablenz; Nicholas J Bird; James M J Weaver; Harry Potts; Cameron T Whitley; Michael A Bookman; Andy G Lynch; Hannah V Meyer; Simon Tavaré; Tobias Janowitz Journal: Clin Cancer Res Date: 2020-12-10 Impact factor: 13.801
Authors: Ramiro Fernandez-Placencia; Francisco Berrospi-Espinoza; Karla Uribe-Rivera; Jose Medina-Cana; Ivan Chavez-Passiuri; Nestor Sanchez-Bartra; Kori Paredes-Galvez; Carlos Luque-Vasquez Vasquez; Juan Celis-Zapata; Eloy Ruiz-Figueroa Journal: Surg Res Pract Date: 2021-02-27