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

Year 2023, Volume: 48 Issue: 2, 336 - 343, 02.07.2023

Osman Erinç , Soner Yeşilyurt , Meliha Nalcaci

https://doi.org/10.17826/cumj.1222031

Abstract

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.

Keywords

multiple myeloma, renal function, renal failure

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

Abstract

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.

Keywords

multiple myeloma, renal function, renal failure

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