Irish Journal of Medical Science

, Volume 178, Issue 3, pp 301–307 | Cite as

Evaluation of carboplatin dosage based on 4-variable modification of diet in renal disease equation

  • A. Barry
  • R. O’Cearbhaill
  • D. Griffin
  • P. Donnellan
  • M. Keane
  • H. Grimes
Original Article

Abstract

Background

Traditionally, carboplatin dosage is based on the Calvert formula. Glomerular filtration rate (GFR) and creatinine clearance (CrCl) are often used interchangeably in this formula. The modification of diet in renal disease (MDRD) equation is now routinely available to estimate GFR (eGFR).

Methods

We performed a retrospective analysis of carboplatin dosage in our institute. Calvert formula derived carboplatin dose using eGFR calculated from the MDRD equation was compared to estimated CrCl from the Cockcroft-Gault and Jelliffe equations.

Results

Ninety-two carboplatin treatment episodes were recorded. eGFR and CrCl correlated reasonably well with a correlation coefficient (r) of 0.88. The correlation was weakest at lower levels of serum creatinine. Correcting eGFR for body surface area resulted in a tighter correlation (r = 0.94).

Conclusion

The MDRD derived eGFR is readily available and may prove very useful in calculating carboplatin dosage for patients with impaired renal function.

Keywords

Carboplatin Creatinine clearance Estimated glomerular filtration rate Calvert formula Modification of diet in renal disease 

References

  1. 1.
    Calvert AH, Newell DR, Gumbrell LA et al (1989) Carboplatin dosage: prospective evaluation of a simple formula based on renal function. J Clin Oncol 7(11):1748–1756PubMedGoogle Scholar
  2. 2.
    Diskin CJ (2007) Creatinine and glomerular filtration rate: evolution of an accommodation. Ann Clin Biochem 44(Pt 1):16–19PubMedCrossRefGoogle Scholar
  3. 3.
    Cockroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16(1):31–41CrossRefGoogle Scholar
  4. 4.
    Jelliffe RW (1973) Letter: creatinine clearance: bedside estimate. Ann Intern Med 79(4):604–605PubMedGoogle Scholar
  5. 5.
    Levey AS, Bosch JP, Lewis JB et al (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130(6):461–470PubMedGoogle Scholar
  6. 6.
    Lamb EJ, Tomson RV, Roderick PJ (2005) Estimating kidney function in adults using formulae. Ann Clin Biochem 42(Pt 5):321–345PubMedCrossRefGoogle Scholar
  7. 7.
    Rainey PM (2006) Automatic reporting of estimated glomerular filtration rate—jumping the gun? Clin Chem 52(12):2184–2187 Epub 2006 Oct 26PubMedCrossRefGoogle Scholar
  8. 8.
    Stevens LA, Coresh J, Greene T et al (2006) Assessing kidney function—measured and estimated glomerular filtration rate. N Engl J Med 354(23):2473–2483PubMedCrossRefGoogle Scholar
  9. 9.
    Giles PD, Fitzmaurice DA (2007) Formula estimation of glomerular filtration rate: have we gone wrong? BMJ 334(7605):1198–1200PubMedCrossRefGoogle Scholar
  10. 10.
    Peake M, Whiting M (2006) Measurement of serum creatinine—current status and future goals. Clin Biochem Rev 27(4):173–184PubMedGoogle Scholar
  11. 11.
    Ando M, Minami H, Ando Y et al (2000) Multi-institutional validation study of carboplatin dosing formula using adjusted serum creatinine level. Clin Cancer Res 6(12):4733–4738PubMedGoogle Scholar
  12. 12.
    Lamb EJ, Vickery S, Dalton RN et al (2006) Estimating GFR with ID-MS traceable creatinine assays. Ann Clin Biochem 43(Pt 4):327PubMedCrossRefGoogle Scholar
  13. 13.
    Poggio ED, Wang X, Greene T et al (2005) Performance of the Cockcroft-Gault and modification of diet in renal disease equations in estimating GFR in ill hospitalized patients. Am J Kidney Dis 46(2):242–252PubMedCrossRefGoogle Scholar
  14. 14.
    Cooper AV, Roques TW (2007) Can MDRD (modification of diet in renal disease) be used to estimate GFR in patients receiving carboplatin? Clin Oncol (R Coll Radiol) 19(3 Suppl):27Google Scholar
  15. 15.
    Saleem M, Florkowski CM, George PM et al (2006) Comparison of two prediction equations with radionuclide glomerular filtration rate: validation in routine use. Ann Clin Biochem 43(Pt 4):309–313PubMedCrossRefGoogle Scholar
  16. 16.
    Poole SG, Dooley MJ, Rischin D (2002) A comparison of bedside renal function estimates and measured glomerular filtration rate (Tc99mDTPA clearance) in cancer patients. Ann Oncol 13(6):949–955PubMedCrossRefGoogle Scholar
  17. 17.
    Nagao S, Fujiwara K, Imafuku N et al (2005) Difference of carboplatin clearance estimated by the Cockroft-Gault, Jelliffe, Modified-Jelliffe, Wright or Chatelut formula. Gynecol Oncol 99(2):327–333PubMedCrossRefGoogle Scholar
  18. 18.
    Ekhart C, de Jonge ME, Huitema AD et al (2006) Flat dosing of carboplatin is justified in adult patients with normal renal function. Clin Cancer Res 12(21):6502–6508PubMedCrossRefGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2008

Authors and Affiliations

  • A. Barry
    • 1
  • R. O’Cearbhaill
    • 2
  • D. Griffin
    • 3
  • P. Donnellan
    • 4
  • M. Keane
    • 4
  • H. Grimes
    • 5
  1. 1.21 Ashley CourtDublin 4Ireland
  2. 2.Department of Medical OncologyBeaumont HospitalDublinIreland
  3. 3.Department of Clinical BiochemistryGalway University HospitalGalwayIreland
  4. 4.Department of Medical OncologyGalway University HospitalGalwayIreland
  5. 5.Department of Clinical BiochemistryGalway University HospitalGalwayIreland

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