ESPN 51th Annual Meeting

ESPN 2018


 
Comparison of eGFR by Schwartz formula with mGFR by DTPA in patients who underwent chemotherapy
SHAGAYEGH SADAT ESMAIL NEZHAD 1 NASRIN ESFANDIAR 1 SHIVA NAZARI 1

1- PEDIATRIC NEPHROLOGY RESEARCH CENTER (PED NRC), SHAHID BEHESHTI MEDICAL UNIVERSITY (SBMU), TEHRAN, IRAN
 
Introduction:

 Chemotherapy induced nephrotoxicity is one of the main causes of morbidity and mortality in children with cancer. However early diagnosis of developing renal impairment is preventable by correct adjustment of nephrotoxic drug doses and also may limit the process of treatment by over-adjusting. So a reliable and accurate GFR calculating method is necessary according to the critical situation of cancer patients.

Material and methods:

 52 children 4months to 14 years with malignancy who were referred to Mofid Children Hospital during 2016-2017 and undergone nephrotoxic chemotherapy entered the study. eGFR was calculated by Schwartz formula before chemotherapy startedand after the chemotherapy period was finished. mGFR by DTPA-Scan was also calculated and two GFR were compared ,also need of drug dosing adjustment was analyzed according to each in each patient.

Results:

 The mean measure of eGFR and mGFR were 74.22 and 92.26 respectively. The comparison of two measures by Schwartz and DTPA showed meaningful statistical difference (paired T-test). Statistical correlation of eGFR and mGFR in every patient was studied by Kappa test which showed significant difference (p-value≤0.05). In the purpose of dosing adjustment, Schwartz formula showed 24% adjustment necessity compared to 6% according to DTPA-scan. Statistical analysis showed 25.5% false positive in GFR calculating by Schwartz method.

Conclusions:

 According to the unreliable serum creatinine level in cancer patients’ eGFR cannot be an accurate and reliable choice of GFR calculation. According to our study results, DTPA-scan would be able to become a method of choice in critical cancer children.