Accuracy of glomerular filtration rate estimation equations in patients with hematopathy

Abstract

Renal dysfunction is a common side-effect of chemotherapeutic agents in patients with hematopathy. Although broadly used, glomerular filtration rate (GFR) estimation equations were not fully validated in this specific population. Thus, this study was designed to further assess the accuracy of various GFR equations, including the newly 2012 CKD-EPI equations. Referring to ^99mTc-DTPA clearance method, three Scr-based (MDRD, Peking, and CKD-EPI_Scr), three Scys C-based (Steven 1, Steven 2, and CKD-EPI_{Scys C}), and three Scr-Scys C combination based (Ma, Steven 3, and CKD-EPI_{Scr-Scys C}) equations were included. Bias, P₃₀, and misclassification rate were applied to compare the applicability of the selected equations. A total of 180 Chinese hematological patients were enrolled. Mean bias, absolute mean bias, P_30, misclassification rate and Bland-Altman plots of the CKD-EPI_{Scr-Scys C} equation were 7.90 mL/minute/1.73 m², 17.77 mL/minute/1.73 m², 73.3%, 38% and 79.7 mL/minute/1.73 m², respectively. CKD-EPI_{Scr-Scys C} predicted the most precise eGFR both in lymphoma and leukemia subgroups. Additionally, CKD-EPI_{Scys C} equation in the rGFR ≧ 90 mL/minute/1.73 m² subgroup and Steven 2 equation in the rGFR<90 mL/minute/1.73 m² subgroup provided more accurate estimates in each subgroup. The CKD-EPI_{Scr-Scys C} equation could be recommended to monitor kidney function in hematopathy patients. The accuracy of GFR equations may be closely related with GFR level and kidney function markers, but not the primary cause of hematopathy.

Keywords

creatinine / cystatin C / equation / glomerular filtration rate / hematopathy

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Acknowledgment

This work was supported by the grants from the Major State Basic Research Development Program of China 2013CB530803, the National Natural Science Foundation of China H0511-81370843 and H0511-81670677, Chinese Society of Nephrology (1502002-0590), the Innovation of Science and Technology Achievement Transformation Fund of Jiangsu Province BL2012066, the Chinese Medical Association of Clinical Medicine Research Special Funds 15020020-590, a Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions JX10231801.

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2018 2018 by the Journal of Biomedical Research.