Yıl: 2023 Cilt: 48 Sayı: 2 Sayfa Aralığı: 336 - 343 Metin Dili: İngilizce DOI: 10.17826/cumj.1222031 İndeks Tarihi: 28-09-2023

Comparison of eGFR formulas (CKD-EPI and MDRD) in patients with multiple myeloma

Öz:
Purpose: Modification of Diet in Renal Disease’ (MDRD) and 'Chronic Kidney Disease Epidemiology Collaboration’ (CKD-EPI) formulas are generally accepted and widely utilized tools to assess renal function. In this study, we aimed to investigate the power of the MDRD and CKD-EPI formulas, which are the two most used formulas in the measurement of eGFR in patients with multiple myeloma (MM). Materials and Methods: A total of 40 patients, newly diagnosis with MM, were consecutively enrolled to the study and their records were analyzed in terms of demographic features and laboratory parameters of the patients, type of paraproteinemia and stage of disease. MDRD and CKD-EPI formulas were used to evaluate renal function. Results: The difference found between basal and third-month estimated Glomerular Filtration Rate (eGFR) using MDRD (61±15.4 mL/min/1.73 m², third month 75±18.2 mL/min/1.73 m²) and CKD-EPI formulas (62±15.7 mL/min/1.73 m², third month 76±18.4 mL/min/1.73 m²) were significant. There was no significant difference between two formulas regarding basal and third month eGFR mean values. According to CKD staging, 12.5% of all subjects changed and 80% of them moved to better stage. Conclusion: CKD-EPI tends to produce higher eGFR values with compared to MDRD, especially when they are used to evaluate mildly impaired renal function. Hence, prevalence of renal disease was determined lower when assessed with CKD-EPI. Therefore, we recommend that it is important to use the same eGFR estimation formula for a consistent outcomes analysis.
Anahtar Kelime: multiple myeloma renal function renal failure CKD-EPI MDRD

Multipl miyelom hastalarında eGFR formüllerinin (CKD-EPI ve MDRD) karşılaştırılması

Öz:
Amaç: Renal Hastalıkta Diyet Modifikasyonu (MDRD) ve Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formülleri renal fonksiyonları değerlendirmede genel kabul gören ve geniş kullanım alanı olan formüllerdir. Çalışmada, Multipl miyelomalı (MM) hastalarda eGFR ölçümünde en sık kullanılan iki formül olan MDRD ve CKD-EPI formüllerinin gücünü araştırmayı amaçladık. Gereç ve Yöntem: Toplam 40 yeni tanı alan MM hastaları çalışmaya alınıp dosyaları demografik özellikler, myelom tipleri, evreleri, laboratuvar verileri açısından retrospektif olarak incelendi. Renal fonksiyonları, MDRD ve CKD-EPI formülleri ile değerlendirildi. Bulgular: Bazal ve 3.ay glomerül filtrasyon hızı değerleri arasında MDRD (61±15.4 mL/dk/1.73 m², 3. ay 75±18.2 mL/min/1.73 m²) ve CKD-EPI(62±15.7 mL/dk/1.73 m², 3 ay 76±18.4 mL/min/1.73 m²) formülleriyle anlamlı fark saptandı. MDRD ve CKD-EPI formülleri arasında bazal ve 3.ay GFH ortalamaları bakımından ise anlamlı fark saptanmadı. KBH evrelemesine göre, tüm katılımcıların %12.5’i evre değiştirirken, bunların %80’inin daha iyi bir evreye geçiş yaptığı saptandı. Sonuç: Böbrek fonksiyon bozukluğu hafif olan hastalarda MDRD ve CKD-EPI formülleri karşılaştırıldığında, CKD-EPI eGFR değerlerini daha yüksek hesaplama eğilimindedir. Böylece CKD-EPI formülü kullanıldığında böbrek hastalığı prevalansı daha düşük saptanmaktadır. Bu sebeple, hasta takibinde tutarlı bir sonuç analizi için aynı GFR tahmin formülünü kullanmanın önemli olduğunu öneriyoruz.
Anahtar Kelime: multiple myeloma renal function renal failure CKD-EPI MDRD

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Rajkumar SV. Multiple myeloma: 2020 update on diagnosis, risk-stratification and management. Am J Hematol. 2020;95:548-67.
  • 2. Sethi S, Rajkumar SV, D'Agati VD. The complexity and heterogeneity of monoclonal immunoglobulin- associated renal diseases. J Am Soc Nephrol. 2018;29:1810-23.
  • 3. Kane SF. Bone tumors: multiple myeloma. FP Essent. 2020;493:30-5.
  • 4. Bridoux F, Carron PL, Pegourie B, Alamartine E, Augeul-Meunier K, Karras A et al. Effect of high- cutoff hemodialysis vs conventional hemodialysis on hemodialysis independence among patients with myeloma cast nephropathy: a randomized clinical trial. JAMA. 2017;5;318:2099-2110.
  • 5. Yan G, Li H, Zhang Y, Xia C, Wang M, Jia Y et al. Renal insufficiency predicts worse prognosis in newly diagnosed IgD multiple myeloma patients. Front Oncol. 2022;12:1012889.
  • 6. Sathick IJ, Drosou ME, Leung N. Myeloma light chain cast nephropathy, a review. J Nephrol. 2019;32:189- 98.
  • 7. Kundu S, Jha SB, Rivera AP, Flores Monar GV, Islam H, Puttagunta SM et al. Multiple myeloma and renal failure: mechanisms, diagnosis, and management. Cureus. 2022;14:e22585.
  • 8. Heher EC, Rennke HG, Laubach JP, Richardson PG. Kidney disease and multiple myeloma. Clin J Am Soc Nephrol. 2013;8:2007-17.
  • 9. Woziwodzka K, Vesole DH, Małyszko J, Batko K, Jurczyszyn A, Koc-Żórawska E et al. New markers of renal failure in multiple myeloma and monoclonal gammopathies. J Clin Med. 2020;9:1652.
  • 10. Zafari N, Churilov L, MacIsaac RJ, Torkamani N, Baxter H, Kiburg KV et al. Diagnostic performance of the chronic kidney disease epidemiology collaboration (ckd-epi) equation at estimating glomerular filtration rate in adults with diabetes mellitus: a systematic review and meta-analysis protocol. BMJ Open. 2019;9:e031558.
  • 11. Schwandt A, Denkinger M, Fasching P, Pfeifer M, Wagner C, Weiland J et al. Comparison of MDRD, CKD-EPI, and Cockcroft-Gault equation in relation to measured glomerular filtration rate among a large cohort with diabetes. J Diabetes Complicat. 2017;31:1376-83.
  • 12. Palacio-Lacambra ME, Comas-Reixach I, Blanco- Grau A, Suñé-Negre JM, Segarra-Medrano A, Montoro-Ronsano JB. Comparison of the Cockcroft- Gault, MDRD and CKD-EPI equations for estimating ganciclovir clearance. Br J Clin Pharmacol. 2018;84:2120-28.
  • 13. Schmidts A, Grünewald J, Kleber M, Terpos E, Ihorst G, Reinhardt H et al. eGFR estimation in lenalidomide treatment of multiple myeloma patients: a prospective cohort study. Clin Exp Nephrol. 2019;23:199-206.
  • 14. Tang B, Tu W, Zhao J, Deng X, Tan I, Butlin M et al. Relationship between Arterial Stiffness and Renal Function Determined by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) Equations in a Chinese Cohort Undergoing Health Examination. Biomed Res Int. 2022;2022:8218053.
  • 15. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI et al. CKD-EPI: A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009 May 5;150:604-12.
  • 16. Chen TK, Knicely DH, Grams ME. Chronic kidney disease diagnosis and management: a review. JAMA. 2019;322:1294-1304.
  • 17. Medical Masterclass contributors; Firth J. Haematology: multiple myeloma. Clin Med (Lond). 2019;19:58-60.
  • 18. Bird S, Cairns D, Menzies T, Boyd K, Davies F, Cook G et al. Sex differences in multiple myeloma biology but not clinical outcomes: results from 3894 patients in the myeloma XI trial. Clin Lymphoma Myeloma Leuk. 2021;2:667-75.
  • 19. Padala SA, Barsouk A, Barsouk A, Rawla P, Vakiti A, Kolhe R et al. Epidemiology, staging, and management of multiple myeloma. Med Sci (Basel). 2021;9:3.
  • 20. Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc. 2003;78:21-33.
  • 21. Prakash J, Mandal AK, Vohra R, Wani IA, Hota JK, Raja R et al. Renal disease is a prodrome of multiple myeloma: an analysis of 50 patients from eastern India. Ren Fail. 2009;31:267-71.
  • 22. Willems JM, Vlasveld T, den Elzen WP, Westendorp RG, Rabelink TJ, de Craen AJ et al. Performance of Cockcroft-Gault, MDRD, and CKD-EPI in estimating prevalence of renal function and predicting survival in the oldest old BMC Geriatr. 2013;13:113.
  • 23. Moazzeni SS, Arani RH, Hasheminia M, Tohidi M, Azizi F, Hadaegh F. High incidence of chronic kidney disease among Iranian diabetic adults: Using CKD- EPI and MDRD equations for estimated glomerular filtration rate. Diabetes Metab J. 2021;45:684-97.
  • 24. Zhou LY, Yin WJ, Zhao J, Zhang BK, Hu C, Liu K et al. A novel creatinine-based equation to estimate glomerular filtration rate in Chinese population with chronic kidney disease: implications for DOACs dosing in atrial fibrillation patients. Front Pharmacol. 2021;19;12:615953.
  • 25. Stevens LA, Li S, Kurella Tamura M, Chen SC, Vassalotti JA, Norris KC et al. Comparison of the CKD-EPI and MDRD study equations: risk factors for and complications of CKD and mortality in the Kidney Early Evaluation Program (KEEP). Am J Kidney Dis. 2011;57:S9-16.
APA Erinc O, yeşilyurt s, Nalcaci M (2023). Comparison of eGFR formulas (CKD-EPI and MDRD) in patients with multiple myeloma. , 336 - 343. 10.17826/cumj.1222031
Chicago Erinc Osman,yeşilyurt soner,Nalcaci Meliha Comparison of eGFR formulas (CKD-EPI and MDRD) in patients with multiple myeloma. (2023): 336 - 343. 10.17826/cumj.1222031
MLA Erinc Osman,yeşilyurt soner,Nalcaci Meliha Comparison of eGFR formulas (CKD-EPI and MDRD) in patients with multiple myeloma. , 2023, ss.336 - 343. 10.17826/cumj.1222031
AMA Erinc O,yeşilyurt s,Nalcaci M Comparison of eGFR formulas (CKD-EPI and MDRD) in patients with multiple myeloma. . 2023; 336 - 343. 10.17826/cumj.1222031
Vancouver Erinc O,yeşilyurt s,Nalcaci M Comparison of eGFR formulas (CKD-EPI and MDRD) in patients with multiple myeloma. . 2023; 336 - 343. 10.17826/cumj.1222031
IEEE Erinc O,yeşilyurt s,Nalcaci M "Comparison of eGFR formulas (CKD-EPI and MDRD) in patients with multiple myeloma." , ss.336 - 343, 2023. 10.17826/cumj.1222031
ISNAD Erinc, Osman vd. "Comparison of eGFR formulas (CKD-EPI and MDRD) in patients with multiple myeloma". (2023), 336-343. https://doi.org/10.17826/cumj.1222031
APA Erinc O, yeşilyurt s, Nalcaci M (2023). Comparison of eGFR formulas (CKD-EPI and MDRD) in patients with multiple myeloma. Cukurova Medical Journal, 48(2), 336 - 343. 10.17826/cumj.1222031
Chicago Erinc Osman,yeşilyurt soner,Nalcaci Meliha Comparison of eGFR formulas (CKD-EPI and MDRD) in patients with multiple myeloma. Cukurova Medical Journal 48, no.2 (2023): 336 - 343. 10.17826/cumj.1222031
MLA Erinc Osman,yeşilyurt soner,Nalcaci Meliha Comparison of eGFR formulas (CKD-EPI and MDRD) in patients with multiple myeloma. Cukurova Medical Journal, vol.48, no.2, 2023, ss.336 - 343. 10.17826/cumj.1222031
AMA Erinc O,yeşilyurt s,Nalcaci M Comparison of eGFR formulas (CKD-EPI and MDRD) in patients with multiple myeloma. Cukurova Medical Journal. 2023; 48(2): 336 - 343. 10.17826/cumj.1222031
Vancouver Erinc O,yeşilyurt s,Nalcaci M Comparison of eGFR formulas (CKD-EPI and MDRD) in patients with multiple myeloma. Cukurova Medical Journal. 2023; 48(2): 336 - 343. 10.17826/cumj.1222031
IEEE Erinc O,yeşilyurt s,Nalcaci M "Comparison of eGFR formulas (CKD-EPI and MDRD) in patients with multiple myeloma." Cukurova Medical Journal, 48, ss.336 - 343, 2023. 10.17826/cumj.1222031
ISNAD Erinc, Osman vd. "Comparison of eGFR formulas (CKD-EPI and MDRD) in patients with multiple myeloma". Cukurova Medical Journal 48/2 (2023), 336-343. https://doi.org/10.17826/cumj.1222031