A prospective study to compare the measured glomerular filtration rate compared to estimated glomerular filtration rate in patients undergoing definitive chemoradiation, with platinum agents for various malignancies

J Cancer Res Ther. 2019 Mar;15(Supplement):S56-S59. doi: 10.4103/0973-1482.204881.

Abstract

Context: Renal function assessment is of paramount importance before using the platinum agents especially cisplatin. Glomerular filtration rate (GFR) estimation by diethyl-triamine-penta-acetic acid (DTPA) scan (measured GFR [mGFR]) is considered gold standard.

Aims: The aim of this study is to know if we can replace the mGFR with the GFR estimation with Cockcroft-Gault formula (eGFR) in patients undergoing chemoradiation.

Settings and design: This is a prospective, descriptive study.

Subjects and methods: Patients who are planned for definitive chemoradiation will be eligible for the study. Renal function will be measured DTPA scan and Cockcroft-Gault (CG) formula. Subgroup analysis based on the weight, age, and sex will be done.

Statistical analysis used: Demographic and renal function parameters were analyzed using summary measures. To test the significance of the difference between mGFR and cGFR, a paired t-test will be used; to look for an association between various estimates of renal function, the Pearson's correlation coefficient will be calculated using a two-tailed test.

Results: Median mGFR of patients was 82.7 (range: 65-125 ml/min, standard deviation [SD] =14.0 ml/min) while the median eGFR as per the CG formula was 83.9 ml/min (range: 37-137 ml/min, SD = 24.4 ml/min). The median mGFR was only 1.2 ml/min lesser when measures by the CG formula with no significance difference between them (P = 0.66, 95% confidence interval: -4.5-6.3).

Conclusions: We concluded that in resource-limited setting eGFR using CG formula can replace mGFR, especially in patients with age <60 years. Although weight did not showed a significant difference by two methods, a study with large sample is needed to confirm the result.

Keywords: Chemoradiation; Cockcroft–Gault formula; cisplatin; estimated glomerular filtration rate; measured glomerular filtration rate.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Chemoradiotherapy / adverse effects*
  • Chemoradiotherapy / methods
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects
  • Female
  • Glomerular Filtration Rate / drug effects*
  • Humans
  • Kidney / drug effects*
  • Kidney / physiopathology
  • Male
  • Middle Aged
  • Neoplasms / blood
  • Neoplasms / therapy*
  • Prospective Studies
  • Radiation-Sensitizing Agents / administration & dosage
  • Radiation-Sensitizing Agents / adverse effects*
  • Radionuclide Imaging / methods
  • Radiopharmaceuticals / administration & dosage
  • Technetium Tc 99m Pentetate / administration & dosage
  • Treatment Outcome

Substances

  • Radiation-Sensitizing Agents
  • Radiopharmaceuticals
  • Cisplatin
  • Technetium Tc 99m Pentetate