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Related Experiment Videos

Measurement of glomerular function during cisplatin therapy.

D G Waller1, L Juer, J S Fleming

  • 1Clinical Pharmacology Group, Southampton General Hospital.

British Journal of Clinical Pharmacology
|March 1, 1991
PubMed
Summary

Predicted creatinine clearance is a useful screening tool for kidney function in patients receiving cisplatin chemotherapy. However, for precise dosing adjustments, isotopically determined glomerular filtration rate (GFR) is recommended due to creatinine method inaccuracies.

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Area of Science:

  • Nephrology
  • Oncology
  • Nuclear Medicine

Background:

  • Cisplatin chemotherapy can cause nephrotoxicity, necessitating accurate monitoring of kidney function.
  • Glomerular filtration rate (GFR) is a key indicator of kidney function.
  • Creatinine-based methods are commonly used to estimate GFR, but their accuracy can be variable.

Purpose of the Study:

  • To compare the accuracy of creatinine-based GFR measurements with 99mTc DTPA plasma clearance in patients undergoing cisplatin therapy.
  • To evaluate the utility of predicted versus measured creatinine clearance for GFR screening in this patient population.

Main Methods:

  • Comparison of measured creatinine clearance (24h unsupervised and 4h supervised collections) and predicted creatinine clearance (using formulae/nomogram) against 99mTc DTPA plasma clearance as the reference GFR.

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  • Patient cohort included individuals prior to and during cisplatin therapy.

    • Main Results:

    • Predicted creatinine clearance correlated better with the reference GFR than measured creatinine clearances.
    • Predicted creatinine clearance demonstrated comparable sensitivity to measured creatinine clearance for GFR screening during cisplatin treatment.
    • Inherent inaccuracies in all creatinine-based methods were noted.

    Conclusions:

    • Predicted creatinine clearance is a viable and sensitive method for initial GFR screening in patients receiving cisplatin.
    • For critical cisplatin dose adjustments (within 20% of the threshold), an isotopically determined GFR is essential to ensure optimal therapeutic outcomes and minimize toxicity.