Evaluation of Serological Indicators and Glomerular Filtration Rate Equations in Chinese Cancer Patients
Yingna Tong, Xiaobin Liu, Mingxiu Guan, Meng Wang, Lufang Zhang, Dong Dong, Ruifang Niu, Fei Zhang, Yunli Zhou
Department of Clinical Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin, China (mainland)
Med Sci Monit 2017; 23:2949-2960
The performance of estimated glomerular filtration rate (eGFR) have been proved to vary according to the races of the target population. The eGFR equations have not been validated in the Chinese cancer population received chemotherapy. Meanwhile, serum cystatin C (CysC), urea, β2 microglobulin (β2-MG), and creatinine (SCr) were also evaluated in a cohort of Chinese cancer patients.
MATERIAL AND METHODS: A total of 1000 cancer patients undergoing combination chemotherapy and 108 healthy volunteers were included in this study, and their renal function parameters were evaluated. The eGFR values were compared with reference GFR (rGFR) according to correlation, consistency, precision, and accuracy. Receiver operating characteristic (ROC) curves were used to evaluate the discriminating ability of the GFR equations and serological indicators of renal function.
RESULTS: (1) The equations contained CysC had the same varying tendency as rGFR in relation to the chemotherapeutic cycle. (2) eGFRscr+cysc and eGFRChinese scr+cysc worked better than the other equations, as indicated by a stronger correlation, less bias, improved precision, higher accuracy, and greater AUC. (3) CysC was more sensitive than the other serological indicators for identifying early renal injury. (4) Each parameter showed different characteristics in subgroups of Chinese cancer patients.
CONCLUSIONS: CysC was the most sensitive marker for early renal injury. Among the 8 most commonly used eGFR equations, the combination equation eGFRscr+cysc and eGFRChinese scr+cysc exhibited the best performance in the assessment of the renal function of Chinese cancer patients.
Keywords: cystatin C, Drug Therapy, Combination, Glomerular Filtration Rate, Renal Insufficiency, Chronic