Impact of estimated glomerular filtration rate based on plasma cystatin C and serum creatinine levels before allogeneic hematopoietic cell transplantation

Hidenori Wada, Junya Kanda, Yu Akahoshi, Hirofumi Nakano, Tomotaka Ugai, Ryoko Yamasaki, Yuko Ishihara, Koji Kawamura, Kana Sakamoto, Masahiro Ashizawa, Miki Sato, Kiriko Terasako-Saito, Shun ichi Kimura, Misato Kikuchi, Hideki Nakasone, Rie Yamazaki, Shinichi Kako, Aki Tanihara, Junji Nishida, Yoshinobu Kanda

Research output: Contribution to journalArticle

Abstract

Background: No standard method for measuring renal function has been established in allogeneic hematopoietic cell transplantation (allo-HCT). Methods: We retrospectively analyzed 80 patients with hematological diseases who underwent allo-HCT at our center. We assessed renal function using creatinine clearance (Ccr), estimated glomerular filtration rate (eGFR) based on creatinine (eGFRcre), eGFR based on cystatin C (eGFRcys), and the average of eGFRcre and eGFRcys (eGFRave). We then evaluated the impact of pre-transplant renal function on the exacerbation of renal function and non-relapse mortality after transplantation. Results: There was a significant correlation between Ccr and eGFRcre, eGFRcys, and eGFRave. eGFRave best predicted the exacerbation of renal function according to the area under the receiver-operating characteristic curve. The cumulative incidence of renal function exacerbation at 1 year was higher in the lower eGFRave group (<90 ml/min/1.73 m2) than in the higher eGFRave group (≥90 ml/min/1.73 m2; 0.85 vs. 0.39, p < 0.001), which was confirmed by a multivariate analysis (HR 2.75, p = 0.001). A lower eGFRave value was a marginally significant factor for non-relapse mortality (HR 3.29, p = 0.076). Conclusion: Among the four parameters, eGFRave best predicted the exacerbation of renal function in allo-HCT. Further, the marginal association between low eGFRave and high non-relapse mortality warrants further study in a prospective study in allo-HCT.

Original languageEnglish
Pages (from-to)271-276
Number of pages6
JournalHematology
Volume23
Issue number5
DOIs
Publication statusPublished - 2018 May 28
Externally publishedYes

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Keywords

  • Allogeneic transplantation
  • creatinine clearance
  • cystatin C
  • estimated glomerular filtration rate

ASJC Scopus subject areas

  • Hematology

Cite this

Wada, H., Kanda, J., Akahoshi, Y., Nakano, H., Ugai, T., Yamasaki, R., Ishihara, Y., Kawamura, K., Sakamoto, K., Ashizawa, M., Sato, M., Terasako-Saito, K., Kimura, S. I., Kikuchi, M., Nakasone, H., Yamazaki, R., Kako, S., Tanihara, A., Nishida, J., & Kanda, Y. (2018). Impact of estimated glomerular filtration rate based on plasma cystatin C and serum creatinine levels before allogeneic hematopoietic cell transplantation. Hematology, 23(5), 271-276. https://doi.org/10.1080/10245332.2017.1396026