CORRELATION OF GLOMERULAR FILTRATION RATE (GFR) ESTIMATION FORMULAE WITH MEASURED GFR IN PEDIATRIC ONCOLOGY PATIENTS

Authors

  • Shazia Pervez National Institute of Child Health Karachi
  • Misbah Anjum
  • Safia Bibi
  • Shazia Kulsoom
  • Wajid Hussain
  • Bilquis Naeem

DOI:

https://doi.org/10.55519/JAMC-04-S4-10133

Keywords:

GFR, Estimation formulae, cancer, Children

Abstract

Background: In patients with malignancy accurate assessment of renal function is important for administration of chemotherapeutic medicines. Measurement of GFR by inulin, EDTA clearance, iohexol and 24 hrs urinary creatinine clearance (Crcl) is cumbersome so creatinine based GFR formulas have been developed for assessment of kidney function and there are variety of GFR formulas available for clinical use. Objective was to determine the correlation of estimated GFR by creatinine-based estimation formulae with measured GFR by 24-hours creatinine clearance. Methods: A cross sectional study was conducted in which all patients who underwent measured GFR (mGFR) assessment at Oncology Unit of NICH between 1st January to 31st December 2019 were enrolled in the study. Estimated Glomerular filtration rate (eGFR) of all these patients was calculated by three formulae Original Schwartz (OS), Updated Schwartz (US) and simple height independent equation (SHID). Correlation was made with mGFR by Crcl taken as gold standard using Pearson’s correlation and Linear regression analysis. Bland Altman analysis was also done to see the agreement between eGFR with mGFR. Results: Total sixty (60) patients were enrolled with mean age of 8.2±3.6 years. All three eGFR formulae exhibited a statistically significant positive correlation with mGFR (p-value <0.01). Linear regression analysis also showed a statistically significant relation between mGFR and eGFRs however, the developed regression models for all three formulae showed a low R2 values. Bland-altman analysis revealed that useful level of agreement does not exist between mGFR and eGFR by OS however, SHID and US were found to be in agreement with mGFR by Crcl. Conclusion: SHID and US equations give a good estimate of GFR and may be used in children with malignancies to estimate GFR.

References

Whiting P, Birnie K, Sterne JA, Jameson C, Skinner R, Phillips B. Accuracy of cystatin C for the detection of abnormal renal function in children undergoing chemotherapy for malignancy: a systematic review using individual patient data. Support Care Cancer 2018;26(5):1635–44.

Sharbaf FG, Farhangi H, Assadi F. Prevention of chemotherapy-induced nephrotoxicity in children with cancer. Int J Prev Med 2017;8:76.

Xiong M, Wang L, Su L, Luo W, Li Y, Li L, et al. Acute kidney injury among hospitalized children with cancer. Pediatr Nephrol 2021;36(1):171–9.

Kazemi R, Saberianpour S, Salehi H, Hatampour M, Sheikhpour E. Different Biomarkers of Acute kidney Injury in Cancer Patients. Iran J Ped Hematol Oncol 2021;11(2):134–41.

Yamazoe T, Akagawa S, Matsuno R, Akagawa Y, Yamanouchi S, Omachi T, et al. Superiority of Cystatin C over Creatinine for Early Diagnosis of Acute Kidney Injury in Pediatric Acute Lymphoblastic Leukemia/Lymphoblastic Lymphoma. Tohoku J Exp Med 2021;254(3):163–70.

Soeorg H, Noortoots A, Karu M, Saks K, Lass J, Lutsar I, et al. Glomerular filtration rate in children and young adults with haemato-oncological disease and infection is best described by three-compartmental iohexol model. Pediatr Blood Cancer 2022;69(1):e29305.

Nakamura N, Watanabe H, Okamura K, Kagami S. Assessment of renal function in Japanese children with malignancies using serum cystatin C. J Med Invest 2018;65(3.4):231–5.

Rechenauer T, Zierk J, Gräfe D, Rascher W, Rauh M, Metzler M. A Comparison of GFR Estimation Formulae in Pediatric Oncology. Klin Pädiatr 2018;230(3):142–50.

Esmaeilnejad SS, Nazari S, Esfandiar N. Comparison Between eGFR by Schwartz Formula with Measured GFR by Radionuclide Diethylenetriamine Pentaacetic Acid Scan (Tc99 DTPA scan), in Patients Undergoing Chemotherapy with Nephrotoxic Drugs. Iran J Kidney Dis 2020;14(6):463–9.

Anjum M, Moorani KN, Naeem B, Kulsoom S, Memon AA. Comparison of three formulae for estimation of glomerular filtration rate in severely malnourished children at tertiary care facility. Pak J Med Sci 2017;33(6):1395–1400.

Schwartz GJ, Haycock GB, Edelmann CM, Spitzer A. A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 1976;58(2):259–63.

Jeong TD, Kim J, Lee W, Chun S, Hong KS, Min WK. Evaluation of the 1B Equation to Estimate Glomerular Filtration Rate in Pediatric Patients with Cancer. Ann Lab Med 2018;38(3):261–5.

Tsushita H, Tanaka R, Suzuki Y, Sato Y, Itoh H. Effects of dose and type of corticosteroids on the divergence between estimated glomerular filtration rates derived from cystatin C and creatinine. J Clin Pharm Ther 2020;45(6):1390–7.

Jones M, Denieffe S, Griffin C, Tinago W, Fitzgibbon MC. Evaluation of cystatin C in malignancy and comparability of estimates of GFR in oncology patients. Pract Lab Med 2017;8:95–104.

Bretagne M, Jouinot A, Durand JP, Huillard O, Boudou Rouquette P, Tlemsani C, et al. Estimation of glomerular filtration rate in cancer patients with abnormal body composition and relation with carboplatin toxicity. Cancer Chemother Pharmacol 2017;80(1):45–53.

Witzel SH, Huang SH, Braam B, Filler G. Estimation of GFR using β-trace protein in children. Clin J Am Soc Nephrol 2015;10(3):401–9.

Chancharoenthana W, Wattanatorn S, Vadcharavivad S, Eiam-Ong S, Leelahavanichkul A. Agreement and precision analyses of various estimated glomerular filtration rate formulae in cancer patients. Sci Rep 2019;9(1):19356.

Schwartz JB. Potential effect of substituting estimated glomerular filtration rate for estimated creatinine clearance for dosing of direct oral anticoagulants. J Am Geriatr Soc 2016;64(10):1996–2002.

Safaei-Asl A, Enshaei M, Heydarzadeh A, Maleknejad S. Correlation between cystatin C-based formulas, Schwartz formula and urinary creatinine clearance for glomerular filtration rate estimation in children with kidney disease. J Renal Inj Prev 2016;5(3):157–61.

Downloads

Published

2022-10-11