The accuracy of estimating equations for the evaluation of kidney function in adult survivors of unilateral, nonmetastatic, non-syndromic Wilms tumor: A pilot study from the St. Jude Lifetime Cohort Study.

Autor: Green DM; Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Wang M; Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Krasin MJ; Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Davidoff AM; Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Srivastava D; Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Jay DW; Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Ness KK; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Shulkin BL; Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Lanctot JQ; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Shelton KC; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Brennan RC; Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Mulrooney DA; Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Ehrhardt MJ; Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Dixon SB; Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Kurt BA; Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Robison LL; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Hudson MM; Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.; Department of Pediatrics, University of Tennessee College of Medicine, Memphis, Tennessee, USA., Spunt SL; Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
Jazyk: angličtina
Zdroj: Pediatric blood & cancer [Pediatr Blood Cancer] 2025 Jan; Vol. 72 (1), pp. e31409. Date of Electronic Publication: 2024 Nov 06.
DOI: 10.1002/pbc.31409
Abstrakt: Background: Adult survivors of unilateral, nonmetastatic, non-syndromic Wilms tumor (WT) treated with whole abdomen radiation therapy (WART) are at risk for impaired kidney function. The impact of bias and accuracy on estimated glomerular filtration rate (eGFR) among adult survivors of WT has not been well documented.
Procedure: We clinically evaluated male and female WT survivors with creatinine and cystatin C, calculated eGFR using the Chronic Kidney Disease-Epidemiology equations with and without cystatin C, and measured 99m Tc diethylenetriamine pentaacetic acid (DTPA) plasma clearance. WT survivors treated with unilateral nephrectomy (UN), non-nephrotoxic chemotherapy (NNC) and WART or treated with UN, no radiation therapy, and NNC were enrolled. Correlations between 99m Tc DTPA clearance and eGFR were calculated. Bias and the percentage of eGFR calculations that differed from the 99m Tc DTPA clearance by 10% or less (P 10 ) or 30% or less (P 30 ) (accuracy) were calculated.
Results: Among female WT survivors, none of the eGFR calculations was statistically significantly correlated with 99m Tc DTPA clearance. Among both unirradiated and WART-treated male WT survivors, 99m Tc DTPA clearance correlated well with eGFR calculations that included creatinine. eGFR calculations that included creatinine were positively biased among female participants compared to 99m Tc DTPA clearance, and no P 30 was greater than 90% among either irradiated males or females.
Conclusions: Among female survivors of unilateral, nonmetastatic, non-syndromic WT who have undergone UN, eGFR is poorly correlated with, is positively biased, and lacks sufficient accuracy, compared to 99m Tc DTPA clearance.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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