Background: The accuracy of the Cockcroft-Gault (CG) equation, the Modification of Diet in Renal Disease (MDRD) equation and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation in cancer patients was tested. An equation for estimating glomerular filtration rate (GFR) was created that was adapted to cancer patients. Methods: Data from 641 oncology patients referred for 51Cr-EDTA measurements were included. Factors that may affect GFR, i.e. gender, hypertension, diabetes, non-steroid anti-inflammatory drugs (NSAID), exposure to chemotherapy, age, weight, height, BMI, body surface area and creatinine value were correlated to 51Cr-EDTA-measured GFR. The significant factors were then included in a multiple regression analysis correlated to the measured GFR (mGFR). Results: The equation of log10 (GFR; ml/min/1.73 m2) = 2.36-0.33*log10 (age) - 0.78*log10 (creatinine) + 0.87*log10 (weight) - 0.03*NSAID*log10 (creatinine) + gender (1 = female, 0 = male)*(0.05*NSAID - 0.003*BMI) was generated. Expressed as a mean (standard deviation) of mGFR <60 ml/min/1.73 m2, this equation, the ‘New Equation', overestimated GFR by 26 (33)%, while CG, MDRD and CKD-EPI overestimated GFR by 26 (40)%, 32 (42)% and 48 (47)%, respectively. For mGFR ≥60 ml/min/1.73 m2, the New Equation underestimated GFR by only 3 (16)%, while CG, MDRD and CKD-EPI overestimated GFR by 12 (25)%, 10 (26)% and 5 (23)%, respectively. Conclusion: This study describes a novel equation with a higher accuracy than other commonly used GFR equations for estimating GFR in cancer patients.

Sanchez-Gonzalez PD, Lopez-Hernandez FJ, Lopez-Novoa JM, Morales AI: An integrative view of the pathophysiological events leading to cisplatin nephrotoxicity. Crit Rev Toxicol 2011;41:803-821.
Widemann BC, Adamson PC: Understanding and managing methotrexate nephrotoxicity. Oncologist 2006;11:694-703.
Farry JK, Flombaum CD, Latcha S: Long-term renal toxicity of ifosfamide in adult patients - 5-year data. Eur J Cancer 2012;48:1326-1331.
Zolezzi C, Ferrari S, Fasano MC, Telentinis L, Bacci G, Pizzoferrato A: Correlation between cystatin C and serum creatinine as markers of renal function in patients with neoplasms of the locomotor system. J Chemotherapy 2001;13:316-323.
Stevens LA, Levey AS: Measured GFR as a confirmatory test for estimated GFR. J Am Soc Nephrol 2009;20:2305-2313.
Calvert AH, Newell DR, Gumbrell LA, O'Reilly S, Burnell M, Boxall FE, Siddik ZH, Judson IR, Gore ME, Wiltshaw E: Carboplatin dosage: prospective evaluation of a simple formula based on renal function. J Clin Oncol 1989;7:1748-1756.
Cockcroft DW, Gault MH: Prediction of creatinine clearance from serum creatinine. Nephron 1976;16:31-41.
Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J: A new equation to estimate glomerular filtration rate. Ann Intern Med 2009;150:604-612.
Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D: A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease study group. Ann Intern Med 1999;130:461-470.
Hartlev LB, Boeje CR, Bluhme H, Palshof T, Rehling M: Monitoring renal function during chemotherapy. Eur J Nucl Med Mol Imaging 2012;39:1478-1482.
Ainsworth NL, Marshall A, Hatcher H, Whitehead L, Whitfield GA, Earl HM: Evaluation of glomerular filtration rate estimation by Cockcroft-Gault, Jelliffe, Wright and Modification of Diet in Renal Disease (MDRD) formulae in oncology patients. Ann Oncol 2012;23:1845-1853.
Faluyi OO, Masinghe SP, Hayward RL, Clive S: Accuracy of GFR estimation by the Cockroft and Gault, MDRD, and Wright equations in oncology patients with renal impairment. Med Oncol 2012;29:755-760.
Fossati P, Prencipe L, Berti G: Enzymic creatinine assay: a new colorimetric method based on hydrogen peroxide measurement. Clin Chem 1983;29:1494-1496.
Rigalleau V, Beauvieux MC, Le Moigne F, Lasseur C, Chauveau P, Raffaitin C, Perlemoine C, Barthe N, Combe C, Gin H: Cystatin C improves the diagnosis and stratification of chronic kidney disease, and the estimation of glomerular filtration rate in diabetes. Diabetes Metab 2008;34:482-489.
de Lemos ML, Hsieh T, Hamata L, Levin A, Swenerton K, Djurdjev O, Vu T, Hu F, Conklin J, Malfair Taylor SC: Evaluation of predictive formulae for glomerular filtration rate for carboplatin dosing in gynecological malignancies. Gynecol Oncol 2006;103:1063-1069.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.