Abstract:Objective To evaluate the applicability of several estimated glomerular filtration rate (eGFR) prediction equations in patients with renal cell carcinoma, and analyze the related factors.Methods A total of 132 patients with renal cell carcinoma were collected in the Department of Urology of the First Affiliated Hospital of Bengbu Medical College from January 2017 to December 2018. Serum creatinine, age, sex, body mass index(BMI), complications and T stage were recorded before operation. Base on the standard result by dectecting exogenous radioactive marker technetium-99m diethylenetriamine penta-acetic acid (99mTc-DTPA), the following eight equations were evaluated with Bland-Altman analysis: modified MDRD-1, modified MDRD-2, CKD-EPI equation, combined SCr and cystatin C equation, Cockcroft-Gault (CG) equation, cystatin C-based equation 1, cystatin C-based equation 2 and simplified MDRD equation. And the influencing factors on these eight equations were analyzed by univariate analysis.Results Compared with the 95% consistency analysis of the eight formulas based on rGFR, the two formulas related to cystatin C underestimated the actual level of GFR, and the other six formulas overestimated the actual level of GFR in different ranges. The three formulas with smaller deviation were CKD-EPI(7.74), combined creatinine cystatin(7.87) and modified MDRD-1(7.98). The three formulas with the lowest percentage out of boundaries were improved MDRD-2(1.98%), improved MDRD-1(2.48%) and C-G formulas(2.97%). The formula with the greatest deviation was improved MDRD-2(22.22). The effects of sex, age, BMI, T stage and complications on the predictive formula were analyzed by univariate analysis. The results showed that there was no significant difference in the results of the eight methods in different sex, BMI and T stages of renal cancer patients(all P values>0.05). Except for cystatin C-1 and cystatin C-2, the results of the other six methods were different in different age groups. The eGFR value decreased with the increase of age, and the difference was statistically significant (all P values<0.05). Similar to the results, except for cystatin C-1 and cystatin C-2, the results of the other six calculation methods in the patients with complications were significantly lower than those in the patients without complications, and the difference was statistically significant (all P values<0.05).Conclusions CKD-EPI, creatinine cystatin and modified MDRD-1 are better for evaluating the applicability of renal cancer patients. The factors affecting the accuracy of eGFR are various. The age of patients and the presence of complications have a greater impact on the consistency of the prediction formula.
刘贝贝, 郭园园, 张家俊, 汪盛, 王成勇, 陈志军, 薛胜, 刘建民. 8种肾小球滤过率预测公式对肾细胞癌患者肾功能评价的适用性及相关因素分析[J]. 中华解剖与临床杂志, 2019, 24(4): 403-409.
Liu Beibei, Guo Yuanyuan, Zhang Jiajun, Wang Sheng, Wang Chengyong, Chen Zhijun, Xue Sheng, Liu Jianmin. The applicability of estimated glomerular filtration rate prediction equations in patients with renal cell carcinoma and analysis of related factors. Chinese Journal of Anatomy and Clinics, 2019, 24(4): 403-409.
Faluyi OO, Masinghe SP, Hayward RL, et al. Accuracy of GFR estimation by the Cockroft and Gault, MDRD, and Wright equations in Oncology patients with renal impairment[J]. Med Oncol, 2012, 29(2): 755-760. DOI:10.1007/s12032-011-9824-0.
[2]
Aapro M, Launay-Vacher V. Importance of monitoring renal function in patients with cancer[J]. Cancer Treat Rev, 2012, 38(3): 235-240. DOI:10.1016/j.ctrv.2011.05.001.
[3]
Arteaga MV, Caballero VM, Rengifo KM. Dosimetry of 99mTc (DTPA, DMSA and MAG3) used in renal function studies of newborns and children[J]. Appl Radiat Isot, 2018, 138: 25-28. DOI:10.1016/j.apradiso.2017.07.054.
[4]
Manevska N, Stojanoski S, Majstorov V, et al. Vesicoureteral reflux detected with (99m)tc-DTPA renal scintigraphy during evaluation of renal function[J]. Open Access Maced J Med Sci, 2016, 4(1): 135-138. DOI:10.3889/oamjms.2016.012.
[5]
Pottel H, Hoste L, Dubourg L, et al. An estimated glomerular filtration rate equation for the full age spectrum[J]. Nephrol Dial Transplant, 2016, 31(5): 798-806. DOI:10.1093/ndt/gfv454.
[6]
Nagai T, Uemura O, Ishikura K, et al. Creatinine-based equations to estimate glomerular filtration rate in Japanese children aged between 2 and 11 years old with chronic kidney disease[J]. Clin Exp Nephrol, 2013, 17(6): 877-881. DOI:10.1007/s10157-013-0799-3.
[7]
Pottel H, Hoste L, Martens F. A simple height-independent equation for estimating glomerular filtration rate in children[J]. Pediatr Nephrol, 2012, 27(6): 973-979. DOI:10.1007/s00467-011-2081-9.
[8]
Mulay AV, Gokhale SM. Comparison of serum creatinine-based estimating equations with gates protocol for predicting glomerular filtration rate in indian population[J]. Indian J Nephrol, 2017, 27(2): 124-128. DOI:10.4103/0971-4065.200515.
[9]
Colantonio LD, Tanner RM, Warnock DG, et al. The role of cystatin-C in the confirmation of reduced glomerular filtration rate among the oldest old[J]. Arch Med Sci, 2016, 12(1): 55-67. DOI:10.5114/aoms.2016.57580.
[10]
Zabell JR, Larson G, Koffel J, et al. Use of the modification of diet in renal disease equation for estimating glomerular filtration rate in the urologic literature[J]. J Endourol, 2016, 30(8): 930-933. DOI:10.1089/end.2016.0143.
[11]
Kikuchi T, Akamatsu H, Mori K, et al. Applicability of the Japanese equation for estimating glomerular filtration rate in patients with advanced-stage thoracic cancer[J]. Respir Investig, 2016, 54(6): 479-483. DOI:10.1016/j.resinv.2016.05.007.
[12]
Chen M, Xia J, Pei G, et al. A more accurate method acquirement by a comparison of the prediction equations for estimating glomerular filtration rate in Chinese patients with obstructive nephropathy[J]. BMC Nephrol, 2016, 17(1): 150. DOI:10.1186/s12882-016-0345-0.
Wang XZ, Yu ZX, Guo RJ, et al. Application of laparospic ultrasonography in surgery of small renal cell carcinoma[J]. Asian Pac J Cancer Prev, 2014, 15(21): 9113-9116. DOI:10.7314/APJCP.2014.15.21.9113.
[15]
Agochukwu N, Shuch B. Clinical management of renal cell carcinoma with venous tumor thrombus[J]. World J Urol, 2014, 32(3): 581-589. DOI:10.1007/s00345-014-1276-7.
[16]
Hakeem A, Bhatti S, Dillie KS, et al. Predictive value of myocardial perfusion single-photon emission computed tomography and the impact of renal function on cardiac death[J]. Circulation, 2008, 118(24): 2540-2549. DOI:10.1161/CIRCULATIONAHA.108.788109.
[17]
Isobe S, Yamada T, Yuba M, et al. Relationship between pre-procedural microalbuminuria and renal functional changes after coronary computed tomography in diabetic patients[J]. J Cardiol, 2017, 69(4): 666-670. DOI:10.1016/j.jjcc.2016.06.005.
[18]
Gofrit ON, Orevi M. Diagnostic challenges of kidney cancer: a systematic review of the role of positron emission tomography-computerized tomography[J]. J Urol, 2016, 196(3): 648-657. DOI:10.1016/j.juro.2016.02.2992.
[19]
Kang YK, Park S, Suh MS, et al. Quantitative single-photon emission computed tomography/computed tomography for glomerular filtration rate measurement[J]. Nucl Med Mol Imaging, 2017, 51(4): 338-346. doi:10.1007/s13139-017-0491-8
Zhao X, Shao Y, Wang Y, et al. New normal values not related to age and sex, of glomerular filtration rate by (99m)Tc-DTPA renal dynamic imaging, for the evaluation of living kidney graft donors[J]. Hell J Nucl Med, 2012, 15(3): 210-214. doi: 10.1967/s002449910057.
[22]
Momin MA, Abdullah MNA, Reza MS. Comparison of relative renal functions calculated with 99mTc-DTPA and 99mTc-DMSA for kidney patients of wide age ranges[J]. Phys Med, 2018, 45: 99-105. DOI:10.1016/j.ejmp.2017.12.005.
[23]
Carter JL, Lane CE, Fan SL, et al. Estimation of residual glomerular filtration rate in peritoneal dialysis patients using cystatin C: comparison with 51Cr-EDTA clearance[J]. Nephrol Dial Transplant, 2011, 26(11): 3729-3732. DOI:10.1093/ndt/gfr112.
[24]
Chaurasia RK, Agrawal RK, Hada R, et al. A comparison of glomerular filtration rate by creatinine based equations and DTPA-renogram in healthy adult kidney donors[J]. JNMA J Nepal Med Assoc, 2013, 52(190): 305-310. DOI: 10.31729/jnma.2111.
[25]
Jessani S, Levey AS, Bux R, et al. Estimation of GFR in South Asians: a study from the general population in Pakistan[J]. Am J Kidney Dis, 2014, 63(1): 49-58. DOI:10.1053/j.ajkd.2013.07.023.
[26]
Inoue T, Kozawa E, Okada H, et al. Noninvasive evaluation of kidney hypoxia and fibrosis using magnetic resonance imaging[J]. J Am Soc Nephrol, 2011, 22(8): 1429-1434. DOI:10.1681/ASN.2010111143.
[27]
Emre T, Kiliçkesmez Ö, Büker A, et al. Renal function and diffusion-weighted imaging: A new method to diagnose kidney failure before losing half function[J]. Radiol Med, 2016, 121(3): 163-172. DOI:10.1007/s11547-015-0579-0.
[28]
Faure A, Panait N, Panuel M, et al. Predicting postnatal renal function of prenatally detected posterior urethral valves using fetal diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient determination[J]. Prenat Diagn, 2017, 37(7): 666-672. DOI:10.1002/pd.5063.