一种用于估算癌症患者肾小球滤过率的新方程。

A new equation for estimating glomerular filtration rate in cancer patients.

作者信息

Giglio Daniel

机构信息

Department of Oncology, Sahlgrenska University Hospital and Department of Pharmacology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.

出版信息

Chemotherapy. 2014;60(1):63-72. doi: 10.1159/000365724. Epub 2014 Nov 21.

DOI:10.1159/000365724

PMID:25428614

Abstract

BACKGROUND

The accuracy of the Cockcroft-Gault (CG) equation, the Modification of Diet in Renal Disease (MDRD) equation and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation in cancer patients was tested. An equation for estimating glomerular filtration rate (GFR) was created that was adapted to cancer patients.

METHODS

Data from 641 oncology patients referred for (51)Cr-EDTA measurements were included. Factors that may affect GFR, i.e. gender, hypertension, diabetes, non-steroid anti-inflammatory drugs (NSAID), exposure to chemotherapy, age, weight, height, BMI, body surface area and creatinine value were correlated to (51)Cr-EDTA-measured GFR. The significant factors were then included in a multiple regression analysis correlated to the measured GFR (mGFR).

RESULTS

The equation of log10 (GFR; ml/min/1.73 m2) = 2.36-0.33log10 (age) - 0.78log10 (creatinine) + 0.87log10 (weight) - 0.03NSAIDlog10 (creatinine) + gender (1 = female, 0 = male)(0.05NSAID - 0.003BMI) was generated. Expressed as a mean (standard deviation) of mGFR <60 ml/min/1.73 m2, this equation, the 'New Equation', overestimated GFR by 26 (33)%, while CG, MDRD and CKD-EPI overestimated GFR by 26 (40)%, 32 (42)% and 48 (47)%, respectively. For mGFR ≥60 ml/min/1.73 m2, the New Equation underestimated GFR by only 3 (16)%, while CG, MDRD and CKD-EPI overestimated GFR by 12 (25)%, 10 (26)% and 5 (23)%, respectively.

CONCLUSION

This study describes a novel equation with a higher accuracy than other commonly used GFR equations for estimating GFR in cancer patients.

摘要

背景

对癌症患者中Cockcroft-Gault（CG）方程、肾脏病饮食改良（MDRD）方程和慢性肾脏病流行病学协作组（CKD-EPI）方程的准确性进行了测试。创建了一个适用于癌症患者的估计肾小球滤过率（GFR）的方程。

方法

纳入了641例接受（51）Cr-EDTA测量的肿瘤患者的数据。将可能影响GFR的因素，即性别、高血压、糖尿病、非甾体抗炎药（NSAID）、化疗暴露、年龄、体重、身高、BMI、体表面积和肌酐值与（51）Cr-EDTA测量的GFR进行相关性分析。然后将显著因素纳入与测量的GFR（mGFR）相关的多元回归分析。

结果

生成了方程log10（GFR；ml/min/1.73 m2）=2.36 - 0.33×log10（年龄） - 0.78×log10（肌酐） + 0.87×log10（体重） - 0.03×NSAID×log10（肌酐） + 性别（1 = 女性，0 = 男性）×（0.05×NSAID - 0.003×BMI）。以mGFR<60 ml/min/1.73 m2的均值（标准差）表示，这个“新方程”高估GFR 26（33）%，而CG、MDRD和CKD-EPI分别高估GFR 26（40）%、32（42）%和48（47）%。对于mGFR≥60 ml/min/1.73 m2，新方程仅低估GFR 3（16）%，而CG、MDRD和CKD-EPI分别高估GFR 12（25）%、10（26）%和5（23）%。