Derivation of New Equations to Estimate Glomerular Filtration Rate in Pediatric Oncology Patients
| Autor: | Deborah A. Ward, David Gregornik, Alejandro R Molinelli, Vinay M. Daryani, Shane J Cross, Rachel C. Brennan, Clinton F. Stewart, Li Tang, Yilun Sun, Jennifer L. Pauley, Jessica K. Roberts, Vanessa E. Millisor |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Adolescent 030232 urology & nephrology Urology Renal function Antineoplastic Agents urologic and male genital diseases Kidney Kidney Function Tests Models Biological Article Carboplatin 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Neoplasms medicine Pediatric oncology Retrospective analysis Humans Derivation Renal Insufficiency Chronic Intensive care medicine Child Retrospective Studies Creatinine business.industry Infant Renal Elimination chemistry Nephrology 030220 oncology & carcinogenesis Child Preschool Pediatrics Perinatology and Child Health Cohort Technetium Tc 99m Pentetate Female Radiopharmaceuticals business Glomerular Filtration Rate |
| Popis: | Monitoring renal function is critical in treating pediatric patients, especially when dosing nephrotoxic agents. We evaluated the validity of the bedside Schwartz and Brandt equations in pediatric oncology patients and developed new equations for estimated glomerular filtration rate (eGFR) in these patients. A retrospective analysis was conducted comparing eGFR using the bedside Schwartz and Brandt equations to measured GFR (mGFR) from technetium-99m diethylenetriamine pentaacetic acid (99mTc-DTPA) between January 2007 and August 2013. An improved equation to estimate GFR was developed, simplified, and externally validated in a cohort of patients studied from September 2013 to June 2015. Carboplatin doses calculated from 99mTc-DTPA were compared with doses calculated by GFR-estimating equations. Overall, the bedside Schwartz and Brandt equations did not precisely or accurately predict measured GFR (mGFR). Using a data subset, we developed a five-covariate equation, which included height, serum creatinine, age, blood urea nitrogen (BUN), and gender, and a simplified version (two-covariates), which contained height and serum creatinine. These equations were used to estimate GFR in 2036 studies, resulting in precise and accurate predictors of mGFR values. Equations were validated in an external cohort of 570 studies; both new equations were more accurate in calculating carboplatin doses than either the bedside Schwartz or Brandt equation. Two new equations were developed to estimate GFR in pediatric oncology patients, both of which did a better job at estimating mGFR than published equations. |
| Databáze: | OpenAIRE |
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