Author/Editor		Štabuc, Borut; Hajdinjak, Tine; Cizej, Tomaž Edvard
Title		Assessment of renal function from creatinine clearance measurement and 131I-hippuran renography in cancer patients before chemotherapy
Translated title		Ocenjevanje ledvične funkcije iz očistka endogenega kreatinina in renografijo z 131I-hipuranom pri onkoloških bolnikih pred kemoterapijo
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 33, št. 2
Publication year		1999
Volume		str. 119-26
Language		eng
Abstract		Background. Serum creatinine and endogenous creatinine clearance (CrCl) are widely used measures of renal function before prescribing nephrotoxic chemotherapy. This study compares the precision and bias in glomerular filtration rate (GFR) estimation without the need to collect urine by using Cockcroft-Gault formula on a single serum creatinine concentration (CrCo) and 131I- hippuran clearance (HC) determined from the renographic curves. Patients and methods. Fourty-seven patients aged between 27 and 73 years were studied. In all patients, we determined serum creatinine concentration, CrCl, CrCo and HC simultaneously before treatment by combined chemotherapy with cisplatin (CDDP) and in 31 patients, before the third cycle. Serum and urine creatinine concentrations were determined with a Hitachi 911, an automated biochemical analyser CrCl was calculated from the urine flow, from the ratio between the serum and urine creatinine concentrations and was standardized for the body surface area. Serum creatinine was used to estimate CrCo using a Cockcroft and Gault formula. HC was determined from 131I-hippuran uptake by both kidneys, results were compared to our Nuclear Medicine Department normal values with regard to the age of each patient. For the evaluation of results, Pearson's correlation coefficient and t-test with 95 % confidence interval were used. Results. The sensitivity of serum creatinine, CrCo and HC to predict CrCl<78 mL/min/1.73m2 was 41 %, 68% and 46% and specificity was 95%, 71 % and 76% respectively. Value of CoCr for prediction of reduced CrCl (sensitivity) was statistically significantly better than the HC (p=0.03). Value of CoCr fnr prediction of normal CrCl (specificity) was as good as HC (p=0.3). Conclusions. CrCl for the GFR estimation in the patients treated with nephrotoxic chemotherapy cannot be changed by CrCo and/or HC.
Summary		Izhodišča. Koncentracija kreatinina v serumu in očistek endogenega kreatinina (CrCl) sta merili, ki se pogosto uporabljata za oceno ledvične funkcije pred predpisovanjem nefrotoksične kemoterapije. V raziskavi smo občutljivost in specifičnost ocene glomerularne filtracije brez zbiranja urina z uporabo Cockroft-Gaultove formule iz koncentracije serumskega kreatinina (CrCo) primerjali z določitvijo očistka hipurana (HC) z renografijo. Bolniki in metode. Vključenih je bilo 47 bolnikov, starih od 27 do 73 let. Pri vseh smo simultano določili koncentracijo kreatinina v serumu, CrCl, CrCo in HC pred zdravljenjem s kombinirano kemoterapijo s cisplatinom (CDDP) in pri 31 bolnikih še pred tretjim krogom kemoterapije. Koncentracije kreatinina v serumu in urinu smo določali z automatiziranim biokemijskim analizatorjem Hitachi 911. CrCl smo izračunali iz pretoka urina in razmerja med koncentracijo kreatinina v serumu in urinu ter standardizirali glede na telesno površino. Iz vrednosti serumske koncentracije kreatinina smo ocenili CrCo z uporabo Cockroft-Gaultove formule. HC smo ocenili z renografijo z 131I-hipuranom in rezultate ovrednotili glede na normalne vrednosti Oddelka za nuklearno medicino, upoštevaje starost preiskovancev. Za statistično analizo smo uporabljali določitev korelacijskih koeficientov po Pearsonu in t-test s 95% intervalom zaupanja. Rezultati. Občutljivost koncentracije kreatinina v serumu, CrCo in HC za napoved znižanega CrCl (<78 mL/min/1.73m2) je bila 41%, 68% in 46%, specifičnost pa 95%, 71% in 76%. Vrednost CoCr za oceno znižanega CrCl (občutljivost) je bila statistično značilno boljša (p=0.03) od HC. Vrednost CoCr za napoved normalnega CrCl (specifičnost) se ni statistično pomembno razlikovala od HC (p=0.3). Zaključki. CrCo in/ali HC ne moreta nadomestiti CrCl za ocenjevanje GFR pri bolnikih, zdravljenih z nefrotoksično kemoterapijo.
Descriptors		MELANOMA STOMACH NEOPLASMS OVARIAN NEOPLASMS METABOLIC CLEARANCE RATE CREATININE GLOMERULAR FILTRATION RATE RADIOISOTOPE RENOGRAPHY KIDNEY FUNCTION TESTS IODOHIPPURIC ACID CISPLATIN