Evaluation of chronic kidney disease in cancer patients: is there a preferred estimation formula?

Intern Med J. 2018 Nov;48(11):1382-1388. doi: 10.1111/imj.13933.

Abstract

Background: The evaluation of chronic kidney disease (CKD) in cancer patients seems to rely mostly on the Cockcroft-Gault (CG) formula or the creatinine levels to adjust treatment dosages which is a practice refuted by internists.

Aims: We evaluate the overall agreement of the CG, modification of diet in renal disease (MDRD) and CKD-epidemiology collaboration equations (CKD-EPI) equation with the newly devised Janowitz and Williams' (JW) equation.

Methods: The renal function was estimated in 235 cancer patients according to the CG, MDRD, body surface area (BSA)-adjusted MDRD, CKD-EPI, BSA-adjusted CKD-EPI and JW formulae.

Results: JW equation was more in agreement with CG and CKD-EPI estimations than the other equations. Taking JW equation as reference, receiver operating characteristic curve analysis showed that CG eGFR had the higher area under the curve when compared with other equations. Hierarchical cluster analysis showed more proximity between CG and JW equations than the other equations.

Conclusion: The newly proposed JW eGFR estimation was more in agreement with CG equation than the other equations.

Keywords: CKD-EPI; Cockcroft-Gault; Janowitz equation; MDRD; kidney function; onconephrology.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Acute Kidney Injury / chemically induced
  • Acute Kidney Injury / diagnosis*
  • Adult
  • Aged
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Area Under Curve
  • Creatinine / blood
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Kidney Function Tests / standards*
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / drug therapy*
  • Predictive Value of Tests
  • Renal Insufficiency, Chronic / chemically induced
  • Renal Insufficiency, Chronic / diagnosis*
  • Renal Insufficiency, Chronic / diet therapy

Substances

  • Antineoplastic Agents
  • Creatinine