Llanos-Paez Carolina C, Staatz Christine, Lawson Rachael, Hennig Stefanie
School of Pharmacy, University of Queensland, Brisbane, Queensland, Australia.
Pharmacy Department, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia.
J Paediatr Child Health. 2018 Feb;54(2):141-147. doi: 10.1111/jpc.13752. Epub 2017 Oct 30.
Glomerular filtration rate (GFR) is estimated daily in paediatric oncology patients; however, few equations, particularly ones that do not include serum creatinine, have been evaluated in this population. We aimed to compare the predictive performance of different equations available to estimate GFR in paediatric oncology patients.
GFR was measured (mGFR) in paediatric oncology patients based on a chromium 51-labeled ethylene diamine tetraacetic acid excretion test. GFR was estimated (eGFR) in these same patients using equations identified from the literature. mGFR and eGFR values were compared, and the predictive performance of various eGFR equations was assessed in terms of their bias, precision and accuracy.
In total, 124 mGFR values ranging from 7 to 146 mL/min were available for analysis from 73 children. Twenty-two equations were identified from the literature. The Flanders metadata equation displayed the lowest absolute bias (mean error of 0.9 mL/min) and the greatest precision (root mean square error of 13.1 mL/min). The univariate Schwartz equation predicted the highest percentage (81.5%) of eGFR values within 30% of mGFR values, and the Rhodin fat-free mass equation predicted the highest percentage (37.1%) of eGFR values within 10% of mGFR values.
A number of equations were identified that could be used to estimate renal function in paediatric oncology patients; however, none was found to be highly accurate. The Flanders metadata equation and univariate Schwartz performed the best in this study, and we would suggest that these two equations may be used cautiously in paediatric oncology patients for clinical decision making, understanding their limitations.
儿科肿瘤患者每日均会估算肾小球滤过率（GFR）；然而，针对该人群评估的估算方程较少，尤其是不包含血清肌酐的方程。我们旨在比较可用于估算儿科肿瘤患者GFR的不同方程的预测性能。
基于铬51标记的乙二胺四乙酸排泄试验测定儿科肿瘤患者的GFR（mGFR）。使用从文献中确定的方程估算这些患者的GFR（eGFR）。比较mGFR和eGFR值，并根据偏差、精密度和准确性评估各种eGFR方程的预测性能。
总共从73名儿童中获得了124个范围在7至146 mL/分钟的mGFR值用于分析。从文献中确定了22个方程。佛兰德斯元数据方程显示出最低的绝对偏差（平均误差为0.9 mL/分钟）和最高的精密度（均方根误差为13.1 mL/分钟）。单变量施瓦茨方程预测的eGFR值在mGFR值的30%范围内的比例最高（81.5%），而罗丁去脂体重方程预测的eGFR值在mGFR值的10%范围内的比例最高（37.1%）。
确定了一些可用于估算儿科肿瘤患者肾功能的方程；然而，未发现有方程具有高度准确性。在本研究中，佛兰德斯元数据方程和单变量施瓦茨方程表现最佳，我们建议在儿科肿瘤患者临床决策中谨慎使用这两个方程，同时了解其局限性。
