为了检查不同计算的估计肾小球滤过率 (eGFR) 公式和测量的肌酐清除率 (CrCI) 在初次诊断肌层浸润性膀胱癌 (MIBC) 时的一致性。我们对接受顺铂治疗的 MIBC 患者进行了多中心分析2011 年至 2021 年间，基于新辅助化疗 (NAC) 和根治性膀胱切除术 (RC) 或单独使用 RC。基线 eGFR 使用 4 个计算血清方程计算，包括 Cockcroft-Gault (CG)、MDRD、CKD-EPI 2009 和种族-免费 CKD-EPI 2021。为了检查计算的 eGFR 与测量的 CrCI 之间的关联，对测定了 24 小时尿液 CrCI 的患者进行了亚组分析。不适合顺铂的定义为 CrCI 和/或 eGFR < 60 mL/min 每 1.73 m2。在 956 名患者中，CG、MDRD、CKD 发现 30.0%、33.3%、31.9% 和 27.7% 不适合顺铂-EPI 和无外消旋 CKD-EPI 方程 (P = .052)。计算出的 eGFR 公式之间的一致性被评为显着（Cohen 的 kappa (k)：0.66-0.95）。在测量 CrCl 的亚组 (n = 245) 中，37 名 (15.1%) 患者的 CrCI 低于 60 mL/分钟。测量的 CrCl 和计算的 eGFR 之间的一致性较差 (ĸ: 0.29-0.40)。所有计算的 eGFR 公式都明显低估了测量的 CrCI。具体而言，78%-87.5% 计算出的 eGFR 在 40 至 59 mL/分钟之间的患者的 CrCI ≥ 60 mL/分钟。比较计算出的 eGFR 公式，相似百分比的 MIBC 患者被认为不适合顺铂治疗。然而，大量患者可以根据测得的 CrCI 进行顺铂适应升级，特别是当计算出的 eGFR 落在 40-59 mL/分钟的灰色范围内时。© 作者 2024 年。由 Oxford 出版大学出版社。

To examine the agreement of different calculated estimated glomerular filtration rate (eGFR) formulas and measured creatinine clearance (CrCI) at the primary diagnosis of muscle-invasive bladder cancer (MIBC).We performed a multicenter analysis of patients with MIBC, treated with cisplatin-based neoadjuvant chemotherapy (NAC) and radical cystectomy (RC), or with RC alone, between 2011 and 2021. Baseline eGFR was computed using 4 calculated serum equations including Cockcroft-Gault (CG), MDRD, CKD-EPI 2009, and race-free CKD-EPI 2021. To examine the association between calculated eGFR and measured CrCI, subgroup analyses were performed among patients in whom measured 24-hour urine CrCl was determined. Cisplatin-ineligibility was defined as CrCI and/or eGFR < 60 mL/minute per 1.73 m2.Of 956 patients, 30.0%, 33.3%, 31.9%, and 27.7% were found to be cisplatin-ineligible by the CG, MDRD, CKD-EPI, and race-free CKD-EPI equations (P = .052). The concordance between calculated eGFR formulas was rated substantial (Cohen's kappa (k): 0.66-0.95). Among the subgroup (n = 245) with measured CrCl, 37 (15.1%) patients had a CrCI less than 60 mL/minute. Concordance between measured CrCl and calculated eGFR was poor (ĸ: 0.29-0.40). All calculated eGFR formulas markedly underestimated the measured CrCI. Specifically, 78%-87.5% of patients with a calculated eGFR between 40 and 59 mL/minute exhibited a measured CrCI ≥ 60 mL/minute.Comparing calculated eGFR formulas, similar percentages of patients with MIBC were deemed cisplatin-ineligible. However, a significant number of patients could be upgraded by being cisplatin-fit based on measured CrCI, particularly when the calculated eGFR was falling within the gray range of 40-59 mL/minute.© The Author(s) 2024. Published by Oxford University Press.