| Full text | |
| Author(s): Show less - |
Costa e Silva, Veronica T.
[1]
;
Gil Jr, Luiz A.
;
Inker, Lesley A.
[2]
;
Caires, Renato A.
[1]
;
Costalonga, Elerson
[1]
;
Coura-Filho, George
[3]
;
Sapienza, Marcelo T.
[4]
;
Castro Jr, Gilberto
;
Estevez-Diz, Maria Dp
[5]
;
Zanetta, Dirce Maria T.
[6]
;
Antonangelo, Leila
[7]
;
Marcal, Lia
[7]
;
Tighiouart, Hocine
[8]
;
Miao, Shiyuan
[2]
;
Mathew, Paul
[9]
;
Levey, Andrew S.
[2]
;
Burdmann, Emmanuel A.
[10]
Total Authors: 17
|
| Affiliation: | [1] Univ Sao Paulo, Fac Med, Inst Canc Estado Sao Paulo, Serv Nefrol, Sao Paulo - Brazil
[2] Tufts Med Ctr, Div Nephrol, Boston, MA 02111 - USA
[3] Univ Sao Paulo, Fac Med, Hosp Clin, Inst Canc Estado Sao Paulo, Serv Med Nucl, Sao Paulo - Brazil
[4] Univ Sao Paulo, Inst Canc Estado Sao Paulo, Radiol & Oncol Dept, Fac Med, Sao Paulo - Brazil
[5] Castro Jr, Jr., Gilberto, Univ Sao Paulo, Hosp Clin, Fac Med, Inst Canc Estado Sao Paulo, Serv Oncol Clin, Sao Paulo - Brazil
[6] Univ Sao Paulo, Sch Publ Hlth, Dept Epidemiol, Sao Paulo - Brazil
[7] Univ Sao Paulo, Div Clin Pathol, Lab Invest Med LIM 03, Med Sch, Sao Paulo - Brazil
[8] Tufts Med Ctr, Inst Clin Res & Hlth Policy Studies, Biostat Epidemiol & Res Design Ctr, Boston, MA 02111 - USA
[9] Tufts Med Ctr, Div Hematol Oncol, Boston, MA 02111 - USA
[10] Univ Sao Paulo, Serv Nefrol, Lab Invest LIM 12, Fac Med, Sao Paulo - Brazil
Total Affiliations: 10
|
| Document type: | Journal article |
| Source: | Kidney International; v. 101, n. 3, p. 607-614, MAR 2022. |
| Web of Science Citations: | 0 |
| Abstract | |
Current guidelines recommend estimating glomerular filtration rate (eGFR) using creatinine (eGFRcr) with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation as the first test for GFR evaluation, but the Cockcroft-Gault (CG) equation is still commonly used in oncology practice and clinical trials despite increasing evidence of its inaccuracy compared to measured GFR (mGFR). Guidelines recommend eGFR using cystatin C (eGFRcys) or both markers (eGFRcr-cys) as a confirmatory test, but neither was carefully evaluated in cancer patients. Therefore, we compared performance of the CKD-EPI equations and others to the CG equation in adults with a variety of solid tumors. The mGFR was determined by plasma clearance of Cr-51-EDTA. Bias was defined as the median of the differences between mGFR and eGFR while accuracy was defined as the percentage of estimates that differed by more than 30% from the measured GFR (1-P30). We prospectively recruited 1,200 patients between April 2015 and September 2017 with a mean age and mGFR of 58.8 years and 78.4 ml/min/1.73m 2 , respectively. Bias among eGFRcr equations varied from -8.1 to +6.1 ml/min/1.73 m(2). CG was the least accurate, 1-P30 (95% confidence interval) was 24.9 (22.4- 27.3)%; CKD-EPI had 1-P30 of 19.1 (16.8-21.2)% while eGFRcr-cys had the best performance: bias -2.0 (-2.6 to -1.1) ml/min/1.73m(2) and 1-P30 7.8 (6.3-9.4)%. Thus, the CG equation should not be preferred over CKD-EPI equation, and eGFRcr-cys can be used as a confirmatory test in adults with solid tumors. Hence, a major policy implication would be to adopt general practice guideline-recommended methods for GFR evaluation in oncology practice and clinical trials. (AU) | |
| FAPESP's process: | 14/19286-4 - Individuals with high risk for acute kidney injury development in clinical relevant situations: a prospective study on epidemiological, diagnostic and prognostic aspects |
| Grantee: | Emmanuel de Almeida Burdmann |
| Support Opportunities: | Research Projects - Thematic Grants |