Journal Information
Vol. 33. Issue 1.
Pages 26-30 (January 2009)
Vol. 33. Issue 1.
Pages 26-30 (January 2009)
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Comparison of two formulae for the calculation of glomerular filtration in the dosage of zoledronic acid
Comparación de dos fórmulas de cálculo de filtrado glomerular en la dosificación del ácido zoledrónico
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E. Ramírez Herráiza,
Corresponding author
rdiez.hugf@salud.madrid.org

Corresponding author.
, N. Garrido Peñoa, R. Díez Fernándeza, A.M. Iglesias Bolañosb, M. Arteta Jiméneza
a Servicio de Farmacia, Hospital Universitario de Getafe, Madrid, Spain
b Servicio de Farmacia, Hospital del Sureste, Madrid, Spain
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Abstract
Objective

To validate the use of a formula that does not require the patient's weight (Levey formula) for calculating creatinine clearance in the adjustment of the dosage of zoledronic acid.

Method

Prospective observational study in which zoledronic acid prescriptions in the Oncology and Haematology departments were recorded over the course of 8 months. The adjustment of the dose of zoledronic acid was carried out in accordance with creatinine clearance obtained using 2 different equations; the Cockcroft-Gault equation which is based on medical records, and the Levey formula which does not require the patient's weight for the calculation. The results of zoledronic acid dosage from both equations were compared using the SPSS statistics programme, via the comparison of the 2 measurements using the t Student-Fisher (t test).

Results

The t test provided a t test value of t=−3.366, with 112 degrees of freedom and a degree of bilateral importance of P=.001. The difference between both measurements was d=−0.051[0.162]) and the confidence interval was 95%, −0.082 to −0.021. From the data obtained in the t test, the degree of bilateral importance (P=.001 <.05) indicated that the results of the test were statistically significant.

Conclusions

The difference between the dosages obtained when comparing both methods of glomerular filtration is statistically significant, although not clinically relevant, therefore the MDRD-4 formula (Levey) could be used if the patient's weight is not available.

Keywords:
Zoledronic acid
Creatinine clearance
Bisphosphonate
Hypercalcaemia
Osseous metastases
Glomerular filtration
Dosage
Resumen
Objetivo

Validar la utilización de una fórmula que no requiera del peso del paciente (fórmula de Levey) para el cálculo del aclaramiento de creatinina en el ajuste de la dosificación del ácido zoledrónico.

Método

Estudio observacional prospectivo en el que se recogen durante un período de 8 meses las prescripciones de ácido zoledrónico realizadas en los servicios de Oncología y Hematología. Se realiza el ajuste de la dosis de ácido zoledrónico de acuerdo con el aclaramiento de creatinina obtenido mediante 2 ecuaciones diferentes: a) la fórmula de Cockcroft-Gault, que es la propuesta en la ficha técnica del medicamento, y b) la fórmula de Levey, que no requiere del peso del paciente para su cálculo. Se comparan los resultados de dosificación de ácido zoledrónico de ambas ecuaciones con el programa estadístico SPSS, mediante la prueba de comparación de 2 medias calculando la t de Student-Fisher (t test).

Resultados

La prueba t proporcionó un valor t=−3,366, con 112 grados de libertad y un grado de significación bilateral p=0,001. La diferencia entre ambas medias ± desviación estándar fue de −0,051 ± 0,162, y el intervalo de confianza del 95%, −0,082 a −0,021. A partir de los datos obtenidos en la prueba estadística t test, el grado de significación bilateral p=0,001<0,05 indicó que el resultado de la prueba era estadísticamente significativo.

Conclusiones

La diferencia de dosis obtenida al comparar ambos métodos de cálculo del filtrado glomerular es estadísticamente significativa, aunque sin relevancia clínica, con lo que se podría utilizar la fórmula de la Modification of Diet in Renal Disease 4 (Levey), si no disponemos del peso del paciente.

Palabras clave:
Ácido zoledrónico
Aclaramiento de creatinina
Bisfosfonatos
Hipercalcemia
Metástasis óseas
Filtración glomerular
Dosificación
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