Tags

Type your tag names separated by a space and hit enter

The Chronic Kidney Disease Epidemiology Collaboration cystatin C (CKD-EPI-CysC) equation has an independent prognostic value for overall survival in newly diagnosed patients with symptomatic multiple myeloma; is it time to change from MDRD to CKD-EPI-CysC equations?
Eur J Haematol. 2013 Oct; 91(4):347-55.EJ

Abstract

OBJECTIVES

The estimation of glomerular filtration rate (eGFR) in multiple myeloma (MM) is based on equations that use serum creatinine (sCr), such as the Modification of Diet in Renal Disease (MDRD) equation. However, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) group has suggested that eGFR based on both sCr and cystatin C (CKD-EPI-sCr-CysC) is more accurate than other formulae for the estimation of kidney dysfunction. The aim of this study was to prospectively evaluate, for the first time in the literature, the CKD-EPI-sCR-CysC formula in newly diagnosed patients with symptomatic MM.

METHODS

We studied 220 newly diagnosed, previously untreated, patients with symptomatic myeloma and calculated eGFR using the MDRD, the CKD-EPI-sCR, the CKD-EPI-CysC, and the CKD-EPI-sCr-CysC equations.

RESULTS

CKD-EPI-sCr-CysC equation detected more myeloma patients with stage 3-5 renal impairment than the MDRD, CKD-EPI, or CKD-EPI-CysC equations: 45% vs. 39.5%, 42.2%, and 43.1%, respectively (P < 0.01). This was also observed in the elderly patients (>70 yrs), while in patients ≤70 yrs, the CKD-EPI-CysC equation managed to identify higher number of patients with stage 3-5 renal impairment (RI) than the other equations. Furthermore, 63 (28.6%) patients with eGFR values by the MDRD formula were reclassified to higher CKD stages according to CKD-EPI-CysC equation. The median overall survival for all patients was 52 months. In the multivariate analysis, that included International Staging System stage, lactate dehydrogenase (LDH) ≥300 U/L and eGFR for each different equation (as a continuous variable), only eGFR that included CysC, but not sCr had independent prognostic value (P = 0.013) along with high LDH (P = 0.029).

CONCLUSIONS

Our results suggest that equations based on CysC reveal higher number of MM patients with RI compared with equations based only in sCr. Furthermore, the CKD-EPI-CysC formula independently predicted for survival. Based on these data, we suggest that CKD-EPI equations based on CysC should substitute MDRD, as it has been suggested for patients with several other renal disorders.

Authors+Show Affiliations

Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Athens, Greece.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23829647

Citation

Terpos, Evangelos, et al. "The Chronic Kidney Disease Epidemiology Collaboration Cystatin C (CKD-EPI-CysC) Equation Has an Independent Prognostic Value for Overall Survival in Newly Diagnosed Patients With Symptomatic Multiple Myeloma; Is It Time to Change From MDRD to CKD-EPI-CysC Equations?" European Journal of Haematology, vol. 91, no. 4, 2013, pp. 347-55.
Terpos E, Christoulas D, Kastritis E, et al. The Chronic Kidney Disease Epidemiology Collaboration cystatin C (CKD-EPI-CysC) equation has an independent prognostic value for overall survival in newly diagnosed patients with symptomatic multiple myeloma; is it time to change from MDRD to CKD-EPI-CysC equations? Eur J Haematol. 2013;91(4):347-55.
Terpos, E., Christoulas, D., Kastritis, E., Katodritou, E., Pouli, A., Michalis, E., Papassotiriou, I., & Dimopoulos, M. A. (2013). The Chronic Kidney Disease Epidemiology Collaboration cystatin C (CKD-EPI-CysC) equation has an independent prognostic value for overall survival in newly diagnosed patients with symptomatic multiple myeloma; is it time to change from MDRD to CKD-EPI-CysC equations? European Journal of Haematology, 91(4), 347-55. https://doi.org/10.1111/ejh.12164
Terpos E, et al. The Chronic Kidney Disease Epidemiology Collaboration Cystatin C (CKD-EPI-CysC) Equation Has an Independent Prognostic Value for Overall Survival in Newly Diagnosed Patients With Symptomatic Multiple Myeloma; Is It Time to Change From MDRD to CKD-EPI-CysC Equations. Eur J Haematol. 2013;91(4):347-55. PubMed PMID: 23829647.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Chronic Kidney Disease Epidemiology Collaboration cystatin C (CKD-EPI-CysC) equation has an independent prognostic value for overall survival in newly diagnosed patients with symptomatic multiple myeloma; is it time to change from MDRD to CKD-EPI-CysC equations? AU - Terpos,Evangelos, AU - Christoulas,Dimitrios, AU - Kastritis,Efstathios, AU - Katodritou,Eirini, AU - Pouli,Anastasia, AU - Michalis,Eurydiki, AU - Papassotiriou,Ioannis, AU - Dimopoulos,Meletios A, AU - ,, Y1 - 2013/08/17/ PY - 2013/06/30/accepted PY - 2013/7/9/entrez PY - 2013/7/9/pubmed PY - 2014/4/22/medline KW - Chronic Kidney Disease Epidemiology Collaboration KW - Modification of Diet in Renal Disease formula KW - cystatin C KW - estimated glomerular filtration rate KW - multiple myeloma KW - renal dysfunction SP - 347 EP - 55 JF - European journal of haematology JO - Eur J Haematol VL - 91 IS - 4 N2 - OBJECTIVES: The estimation of glomerular filtration rate (eGFR) in multiple myeloma (MM) is based on equations that use serum creatinine (sCr), such as the Modification of Diet in Renal Disease (MDRD) equation. However, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) group has suggested that eGFR based on both sCr and cystatin C (CKD-EPI-sCr-CysC) is more accurate than other formulae for the estimation of kidney dysfunction. The aim of this study was to prospectively evaluate, for the first time in the literature, the CKD-EPI-sCR-CysC formula in newly diagnosed patients with symptomatic MM. METHODS: We studied 220 newly diagnosed, previously untreated, patients with symptomatic myeloma and calculated eGFR using the MDRD, the CKD-EPI-sCR, the CKD-EPI-CysC, and the CKD-EPI-sCr-CysC equations. RESULTS: CKD-EPI-sCr-CysC equation detected more myeloma patients with stage 3-5 renal impairment than the MDRD, CKD-EPI, or CKD-EPI-CysC equations: 45% vs. 39.5%, 42.2%, and 43.1%, respectively (P < 0.01). This was also observed in the elderly patients (>70 yrs), while in patients ≤70 yrs, the CKD-EPI-CysC equation managed to identify higher number of patients with stage 3-5 renal impairment (RI) than the other equations. Furthermore, 63 (28.6%) patients with eGFR values by the MDRD formula were reclassified to higher CKD stages according to CKD-EPI-CysC equation. The median overall survival for all patients was 52 months. In the multivariate analysis, that included International Staging System stage, lactate dehydrogenase (LDH) ≥300 U/L and eGFR for each different equation (as a continuous variable), only eGFR that included CysC, but not sCr had independent prognostic value (P = 0.013) along with high LDH (P = 0.029). CONCLUSIONS: Our results suggest that equations based on CysC reveal higher number of MM patients with RI compared with equations based only in sCr. Furthermore, the CKD-EPI-CysC formula independently predicted for survival. Based on these data, we suggest that CKD-EPI equations based on CysC should substitute MDRD, as it has been suggested for patients with several other renal disorders. SN - 1600-0609 UR - https://www.unboundmedicine.com/medline/citation/23829647/The_Chronic_Kidney_Disease_Epidemiology_Collaboration_cystatin_C__CKD_EPI_CysC__equation_has_an_independent_prognostic_value_for_overall_survival_in_newly_diagnosed_patients_with_symptomatic_multiple_myeloma L2 - https://doi.org/10.1111/ejh.12164 DB - PRIME DP - Unbound Medicine ER -