Kidney Res Clin Pract.  2017 Dec;36(4):342-348. 10.23876/j.krcp.2017.36.4.342.

Cockcroft-Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease Epidemiology Collaboration equations for estimating glomerular filtration rates in cancer patients receiving cisplatin-based chemotherapy

Affiliations
  • 1Division of Hematology-Oncology, Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
  • 2Department of Laboratory Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
  • 3Division of Nephrology, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea. zhidao79@naver.com

Abstract

BACKGROUND
Although the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation has been recommended for accurate estimates of glomerular filtration rate (eGFR), there is little information regarding differences in GFR estimates obtained using the Cockcroft-Gault (CG) or Modification of Diet in Renal Disease (MDRD) equations in East Asian cancer patients. We investigated discrepancies in GFR and toxicities in patients treated with cisplatin-based chemotherapy using three equations equations.
METHODS
A total of 229 patients were retrospectively recruited. We calculated eGFR using the three equations and separated patients into three categories based on GFR < 10 (group A), 10-50 (group B), and > 50 (group C) mL/min/1.73m2. We analyzed chemotherapy toxicities.
RESULTS
The mean eGFR calculated using the CG was the lowest of the values derived using the three equations. Estimates using the MDRD and CKD-EPI equations resulted in reclassifying 32 (71.1%) and 33 (73.3%) of 45 patients, originally placed in group B using the CG into group C. However, only 1 (7.7%) of 13 patients placed in group B using the MDRD were reclassified into group C using the CKD-EPI. Twenty-eight of 45 patients classified into group B using the CG equation were treated with reduced doses of cisplatin. However, these patients did not show significant differences in toxicities compared with other patients taking full doses of cisplatin.
CONCLUSION
The CG equations underestimated GFR compared to the MDRD and CKD-EPI equations. Therefore, when GFR is estimated using CG equations, East Asian cancer patients may receive insufficient doses of chemotherapeutic agents, including cisplatin.

Keyword

Cisplatin; Chronic Kidney Disease Epidemiology Collaboration equation; Glomerular filtration rate

MeSH Terms

Asian Continental Ancestry Group
Cisplatin
Cooperative Behavior*
Diet*
Drug Therapy*
Epidemiology*
Glomerular Filtration Rate*
Humans
Renal Insufficiency, Chronic*
Retrospective Studies
Cisplatin
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