Accuracy of glomerular filtration rate estimationequations in patients with hematopathy

Renal dysfunction is a common side-effect of chemotherapeuticagents in patients with hematopathy. Although broadly used, glomerularfiltration rate (GFR) estimation equations were not fully validatedin this special population. Thus, this study was designed to furtherassess the accuracy of various GFR equations, including the newly2012 CKD-EPI equations. Referring to ^99mTc-DTPA clearance method, three Scr-based (MDRD, Peking, and CKD-EPI_Scr), three Scys C-based (Steven 1, Steven 2, and CKD-EPI_{Scys C}), and three Scr-Scys C combination based (Ma,Steven 3, and CKD-EPI_{Scr-Scys C}) equationswere included. Bias, P₃₀, and misclassificationrate were applied to compare the applicability of the selected equations.A total of 180 Chinese hematological patients were enrolled. Meanbias, absolute mean bias, P_30, misclassificationrate and Bland-Altman plots of the CKD-EPI_{Scr-Scys C} equation were 7.90 mL/minute/1.73 m²,17.77 mL/minute/1.73 m², 73.3%, 38% and79.7 mL/minute/1.73 m², respectively. CKD-EPI_{Scr-Scys C} predicted the most precise eGFR both in lymphomaand leukemia subgroups. Additionally, CKD-EPI_{Scys C} equation in rGFR ≧ 90 mL/minute/1.73 m² subgroup and Steven 2 equation in rGFR<90 mL/minute/1.73 m² subgroup provided relatively more accurate estimatesin each subgroup.The CKD-EPI_{Scr-Scys C} equationcould be recommended to monitor kidney function in blood patients.The accuracy of GFR equations might be closely related with GFR leveland kidney function markers, but not the primary cause of hematopathy.