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Annals of Oncology 13:949-955, 2002
© 2002 European Society for Medical Oncology

Original Paper

A comparison of bedside renal function estimates and measured glomerular filtration rate (Tc99mDTPA clearance) in cancer patients

S. G. Poole1,+, M. J. Dooley1,2 and D. Rischin3

1Department of Pharmacy and 3Department of Medical Oncology, Peter MacCallum Cancer Institute, East Melbourne, Victoria; 2Department of Pharmacy Practice, Victorian College of Pharmacy, Monash University, Parkville, Victoria, Australia

Received 10 July 2001; revised 15 January 2002; accepted 11 February 2002.

Background

The aim of this study was to compare measured glomerular filtration rate (GFR) with estimates of GFR derived from the population pharmacokinetic methods of Martin and Wright, and the creatinine clearance (CrCl) estimates of Cockcroft and Gault, and Jelliffe.

Patients and methods

GFR was determined by technetium-99m diethyl triamine penta-acetic acid (Tc99mDTPA) clearance in adult cancer patients. Height, actual body weight and serum creatinine were measured, and GFR and CrCl estimates calculated.

Results

One hundred and twenty-two patients were included. The mean measured GFR was 87 ml/min (range 30–174 ml/min). The mean bias (mean percentage error) was 2, 1, –10 and –17%, and the mean precision (mean absolute percentage error) was 18, 19, 21 and 23% for the Wright, Martin, Cockcroft and Gault, and Jelliffe formulas, respectively. The Martin formula significantly underestimates GFR for females (mean bias –10%) and overestimates GFR for males (mean bias 8%) (P <0.001 for bias of males versus females). The Wright and Martin formulas significantly overestimate GFR <50 ml/min (mean bias 39 and 30%; P = 0.03 and 0.05, respectively) and all formulas underestimate GFR >100 ml/min (mean bias –18, –16, –24 and –32% for Wright, Martin, Cockcroft and Gault, and Jelliffe formulas, respectively; P <0.001).

Conclusions

All the assessed estimates for renal function were found to have significant limitations.

Key words: Cockcroft and Gault formula, creatinine clearance, glomerular filtration rate, technetium-99m diethyl triamine penta-acetic acid (Tc99mDTPA)


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