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Estimation of glomerular filtration rate in cancer patients

Lookup NU author(s): Professor Alan Boddy, Dr Martin Highley, Dr John Fenwick, Professor Alan Calvert

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Abstract

The frequent need to obtain an estimate of renal function in cancer patients, not least for targeting carboplatin dose, has led to a number of approaches to estimate glomerular filtration rate (GFR). This study aimed to develop a simple and reliable method to estimate GFR using readily-available patient characteristics. Data from 62 patients with estimates of 51Cr-EDTA clearance were analysed to determine the most appropriate formula relating this method of measuring GFR to patient characteristics. The population pharmacokinetics of 51Cr-EDTA were analysed using NONMEM to evaluate the influence of each covariate. The formulae derived were then validated using a further 38 patients and compared with those obtained using existing formulae. 51Cr-EDTA clearance (GFR) was positively related to Dubois surface area, negatively related to age, and inversely related to serum creatinine (SCr). Females had lower 51Cr-EDTA clearance than males. The enzymatic method of SCr assay gave more reliable results than the Jaffe colorimetric method. A measure of creatine kinase significantly improved the estimation of GFR. The new formula produced estimates of GFR which were less biased (Mean Prediction Error = -3%) and more precise (Mean Absolute Prediction Error = 12%) than Cockcroft and Gault (-8% and 16%) or Jelliffe (-15% and 19%) estimates. The formulae developed here can be used to provide reliable estimates of GFR, particularly in regard to targeted dosing of carboplatin. © 2001 Cancer Research Campaign.


Publication metadata

Author(s): Wright, J., Boddy, A. V., Highley, M., Fenwick, J., McGill, A., Calvert, A. H.

Publication type: Article

Publication status: Published

Journal: British Journal of Cancer

Year: 2001

Volume: 84

Issue: 4

Pages: 452-459

Print publication date: 01/01/2001

ISSN (print): 0007-0920

ISSN (electronic): 1532-1827

URL: http://dx.doi.org/10.1054/bjoc.2000.1643

DOI: 10.1054/bjoc.2000.1643

PubMed id: 11207037


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