CamGFR v2: A New Model for Estimating the Glomerular Filtration Rate from Standardized or Non-standardized Creatinine in Patients with Cancer
| Autor: | Claire M. Connell, Harry Potts, Tobias Janowitz, Simon Tavaré, Cameron T. Whitley, James M.J. Weaver, Hassal Lee, Taehoon Ha, Eva C. Gablenz, Edward H. Williams, Michael A. Bookman, Nicholas J. Bird, Daniel Giglio, Hannah Meyer, Andy G. Lynch, Thomas R. Flint |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty 030232 urology & nephrology Urology Renal function Article 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Neoplasms medicine Humans In patient Dosing Creatinine Models Statistical business.industry Cancer Middle Aged medicine.disease Prognosis Carboplatin Oncology chemistry Creatinine Measurement 030220 oncology & carcinogenesis Female business Kidney disease Follow-Up Studies Glomerular Filtration Rate |
| Zdroj: | Clin Cancer Res |
| ISSN: | 1557-3265 |
| Popis: | Purpose: Management of patients with cancer, specifically carboplatin dosing, requires accurate knowledge of glomerular filtration rate (GFR). Direct measurement of GFR is resource limited. Available models for estimated GFR (eGFR) are optimized for patients without cancer and either isotope dilution mass spectrometry (IDMS)- or non-IDMS–standardized creatinine measurements. We present an eGFR model for patients with cancer compatible with both creatinine measurement methods. Experimental Design: GFR measurements, biometrics, and IDMS- or non-IDMS–standardized creatinine values were collected for adult patients from three cancer centers. Using statistical modeling, an IDMS and non-IDMS creatinine-compatible eGFR model (CamGFR v2) was developed. Its performance was compared with that of the existing models Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Modification of Diet in Renal Disease (MDRD), Full Age Spectrum (FAS), Lund–Malmö revised, and CamGFR v1, using statistics for bias, precision, accuracy, and clinical robustness. Results: A total of 3,083 IDMS- and 4,612 non-IDMS–standardized creatinine measurements were obtained from 7,240 patients. IDMS-standardized creatinine values were lower than non-IDMS–standardized values in within-center comparisons (13.8% lower in Cambridge; P < 0.0001 and 19.3% lower in Manchester; P < 0.0001), and more consistent between centers. CamGFR v2 was the most accurate [root-mean-squared error for IDMS, 14.97 mL/minute (95% confidence interval, 13.84–16.13) and non-IDMS, 15.74 mL/minute (14.86–16.63)], most clinically robust [proportion with >20% error of calculated carboplatin dose for IDMS, 0.12 (0.09–0.14) and non-IDMS, 0.17 (0.15–0.2)], and least biased [median residual for IDMS, 0.73 mL/minute (−0.68 to 2.2) and non-IDMS, −0.43 mL/minute (−1.48 to 0.91)] eGFR model, particularly when eGFR was larger than 60 ml/minute. Conclusions: CamGFR v2 can utilize IDMS- and non-IDMS–standardized creatinine measurements and outperforms previous models. CamGFR v2 should be examined prospectively as a practice-changing standard of care for eGFR-based carboplatin dosing. |
| Databáze: | OpenAIRE |
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