Davila E, Gardner L B
Cancer. 1987 Jul 15;60(2):161-4. doi: 10.1002/1097-0142(19870715)60:2<161::aid-cncr2820600206>3.0.co;2-v.
The creatinine clearance was calculated in standard fashion from a timed urine specimen (measured creatinine clearance [MCC]) and from a previously published formula (estimated creatinine clearance [ECC]), in 55 instances, in 19 consecutive patients who were admitted to the hospital for treatment with cisplatin. Using creatinine excretion as an index of completeness of urine collection, there were 19 (35%) inaccurate collections. The correlation between creatinine clearances calculated by both methods was excellent (r = 0.684, P less than .001) and improved when inaccurate collections were excluded (r = 0.922, P less than 0.001). A discrepancy between the two methods of 25% or more was found in 19 collections. Using data from patients with two or more collections to test whether or not the two methods produced equally variable results, indicated that the MCC is a more variable, less reliable method than the ECC. In eight of 55 urine collections, the results of MCC were not used as a guide to chemotherapy and, in an additional 16 should have not been used because of inaccuracy in the urine collection. These results suggest that the creatinine clearance as calculated by an alternative method (ECC) should replace the use of MCC when assessment of the renal function is needed before the administration of nephrotoxic agents.
对19例因顺铂治疗入院的连续患者，共55次测定，采用标准方法，根据定时尿标本计算肌酐清除率（实测肌酐清除率[MCC]），并依据先前发表的公式计算肌酐清除率（估计肌酐清除率[ECC]）。以肌酐排泄量作为尿液收集完整性的指标，发现有19次（35%）收集不准确。两种方法计算的肌酐清除率之间相关性良好（r = 0.684，P <.001），排除不准确收集后相关性改善（r = 0.922，P < 0.001）。在19次收集结果中，发现两种方法之间的差异达25%或更多。利用有两次或更多次收集结果的患者数据来检验两种方法产生的结果变异性是否相同，结果表明MCC比ECC变异性更大、可靠性更低。在55次尿液收集结果中，有8次MCC结果未被用作化疗指导，另有16次因尿液收集不准确本不应被采用。这些结果表明，在使用肾毒性药物前需要评估肾功能时，采用替代方法（ECC）计算的肌酐清除率应取代MCC的使用。
