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评估一种基于非胱抑素 C 的新型算法,以计算接受卡铂治疗的癌症患者的个体肾小球滤过率。

Evaluation of a non cystatin-C-based novel algorithm to calculate individual glomerular filtration rate in cancer patients receiving carboplatin.

机构信息

Department of Hospital Pharmacy, Roentgenweg 9, Tuebingen, Germany.

出版信息

Cancer Chemother Pharmacol. 2011 Sep;68(3):693-701. doi: 10.1007/s00280-010-1537-0. Epub 2010 Dec 7.

Abstract

PURPOSE

The purpose of this study was to determine the potential utility of a novel algorithm to calculate individual GFR values in cancer patients. Based on carboplatin AUC measurements the algorithm-based values were compared with results related to other routinely used equations.

METHODS

The association between measured and predicted carboplatin AUC was examined by the Bland-Altman analysis to determine bias and precision. Based on the Calvert formula, GFR values assessed by different routes of calculation including the novel algorithm were compared with each other in individual patients.

RESULTS

The mean absolute administered carboplatin dose was 498 mg and the mean measured carboplatin AUC 5.8 mg/ml × min. Compared to the novel algorithm, the degree of bias to calculate carboplatin AUC was greater with the Cockcroft-Gault, Chatelut, Hoek and Schmitt formula which includes cystatin C as a parameter. In selected patients, algorithm-based GFR values were closer to GFR according to the Calvert formula than results of other equations, including the Jelliffe formula.

CONCLUSION

These results suggest that the concept of a non cystatin C-based novel algorithm including three different formulas rather than one single equation may improve accurate estimation of GFR over a broad range of constitutive values, including patients with low constitutive renal function as well as overweight patients.

摘要

目的

本研究旨在确定一种新算法在癌症患者中计算个体肾小球滤过率(GFR)值的潜在应用价值。基于卡铂 AUC 测量值,将基于算法的数值与其他常用方程的结果进行比较。

方法

通过 Bland-Altman 分析检查测量和预测的卡铂 AUC 之间的关联,以确定偏差和精密度。根据 Calvert 公式,在个体患者中比较不同计算途径(包括新算法)评估的 GFR 值。

结果

平均给予的卡铂剂量为 498mg,平均测量的卡铂 AUC 为 5.8mg/ml×min。与新算法相比,包括胱抑素 C 作为参数的 Cockcroft-Gault、Chatelut、Hoek 和 Schmitt 公式计算卡铂 AUC 的偏差程度更大。在选定的患者中,基于算法的 GFR 值比其他方程(包括 Jelliffe 公式)的结果更接近根据 Calvert 公式计算的 GFR 值。

结论

这些结果表明,一种不基于胱抑素 C 的新算法的概念,包括三个不同的公式而不是一个单一的公式,可能会在广泛的固有值范围内改善 GFR 的准确估计,包括固有肾功能较低的患者和超重患者。

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