Evaluation of a non cystatin-C-based novel algorithm to calculate individual glomerular filtration rate in cancer patients receiving carboplatin.
OBJECTIVE
The purpose of this study was to determine the potential utility of a novel algorithm to calculate individual GFR values in cancer patients. Based on carboplatin AUC measurements the algorithm-based values were compared with results related to other routinely used equations.


METHODS
The association between measured and predicted carboplatin AUC was examined by the Bland-Altman analysis to determine bias and precision. Based on the Calvert formula, GFR values assessed by different routes of calculation including the novel algorithm were compared with each other in individual patients.


RESULTS
The mean absolute administered carboplatin dose was 498 mg and the mean measured carboplatin AUC 5.8 mg/ml × min. Compared to the novel algorithm, the degree of bias to calculate carboplatin AUC was greater with the Cockcroft-Gault, Chatelut, Hoek and Schmitt formula which includes cystatin C as a parameter. In selected patients, algorithm-based GFR values were closer to GFR according to the Calvert formula than results of other equations, including the Jelliffe formula.


CONCLUSIONS
These results suggest that the concept of a non cystatin C-based novel algorithm including three different formulas rather than one single equation may improve accurate estimation of GFR over a broad range of constitutive values, including patients with low constitutive renal function as well as overweight patients.
Department of Hospital Pharmacy, Roentgenweg 9, Tuebingen, Germany. karin.holweger@med.uni-tuebingen.de
Karin
K
Holweger
Hans-Peter
HP
Lipp
Jos H
JH
Beijnen
Carsten
C
Bokemeyer
Joerg Thomas
JT
Hartmann
D000368:Aged; D000465:Algorithms; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D019540:Area Under Curve; D001806:Blood Urea Nitrogen; D015992:Body Mass Index; D016190:Carboplatin / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000652:urine*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000378:metabolism*; D009765:Obesity / Q000150:complications / Q000378:metabolism; D051437:Renal Insufficiency / Q000150:complications / Q000378:metabolism; D015203:Reproducibility of Results; D012709:Serum Albumin / Q000032:analysis
D000970:Antineoplastic Agents; D055316:Cystatin C; D012709:Serum Albumin; D003404:Creatinine; D016190:Carboplatin