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Prediction of glomerular filtration rate in renal transplant recipients: cystatin C or modification of diet in renal disease equation?
Clin Transplant. 2006 Mar-Apr; 20(2):200-5.CT

Abstract

BACKGROUND

To overcome disadvantages of serum creatinine two strategies have been suggested to identify patients with reduced glomerular filtration rate (GFR). On the one hand, the Modification of Diet in Renal Disease (MDRD) equation is now recommended to classify the stage of chronic kidney disease. On the other hand, cystatin C (Cys C) has been investigated in numerous studies, finding a higher sensitivity than creatinine in detecting diminished GFR. To date, no comparison of both strategies in patients after renal transplantation has been performed.

METHODS

One hundred and five consecutive renal transplant recipients underwent (99m)Tc-DTPA-- clearance measurement. Simultaneously, MDRD estimates were calculated and Cys C serum levels were determined. ROC analyses were performed at different decision points from 20 to 70 mL/min/1.73 m(2).

RESULTS

Although the area under the curve did not differ significantly between MDRD and Cys C within the tested GFR range, the AUC for Cys C tended to be higher when GFR exceeded 55 mL/min/1.73 m(2). A significantly higher diagnostic accuracy for Cys C compared with MDRD (p = 0.045 at 65 mL/min/1.73 m(2)) was found when investigating the subgroup of patients with well-functioning grafts (GFR>40 mL/min/1.73 m(2)).

CONCLUSION

MDRD equation is equivalent to Cys C measurement in renal transplant recipients. As availability of MDRD is superior to Cys C, we recommend GFR estimation using the MDRD equation. Nevertheless, Cys C may serve as a confirmation test of high MDRD estimates in patients with well-functioning grafts because of superior accuracy in these patients.

Authors+Show Affiliations

Department of Internal Medicine I, University of Bonn, Bonn, Germany.No 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

16640527

Citation

Pöge, Uwe, et al. "Prediction of Glomerular Filtration Rate in Renal Transplant Recipients: Cystatin C or Modification of Diet in Renal Disease Equation?" Clinical Transplantation, vol. 20, no. 2, 2006, pp. 200-5.
Pöge U, Gerhardt T, Stoffel-Wagner B, et al. Prediction of glomerular filtration rate in renal transplant recipients: cystatin C or modification of diet in renal disease equation? Clin Transplant. 2006;20(2):200-5.
Pöge, U., Gerhardt, T., Stoffel-Wagner, B., Palmedo, H., Klehr, H. U., Sauerbruch, T., & Woitas, R. P. (2006). Prediction of glomerular filtration rate in renal transplant recipients: cystatin C or modification of diet in renal disease equation? Clinical Transplantation, 20(2), 200-5.
Pöge U, et al. Prediction of Glomerular Filtration Rate in Renal Transplant Recipients: Cystatin C or Modification of Diet in Renal Disease Equation. Clin Transplant. 2006 Mar-Apr;20(2):200-5. PubMed PMID: 16640527.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prediction of glomerular filtration rate in renal transplant recipients: cystatin C or modification of diet in renal disease equation? AU - Pöge,Uwe, AU - Gerhardt,Thomas, AU - Stoffel-Wagner,Birgit, AU - Palmedo,Holger, AU - Klehr,Hans-Ulrich, AU - Sauerbruch,Tilman, AU - Woitas,Rainer P, PY - 2006/4/28/pubmed PY - 2006/10/6/medline PY - 2006/4/28/entrez SP - 200 EP - 5 JF - Clinical transplantation JO - Clin Transplant VL - 20 IS - 2 N2 - BACKGROUND: To overcome disadvantages of serum creatinine two strategies have been suggested to identify patients with reduced glomerular filtration rate (GFR). On the one hand, the Modification of Diet in Renal Disease (MDRD) equation is now recommended to classify the stage of chronic kidney disease. On the other hand, cystatin C (Cys C) has been investigated in numerous studies, finding a higher sensitivity than creatinine in detecting diminished GFR. To date, no comparison of both strategies in patients after renal transplantation has been performed. METHODS: One hundred and five consecutive renal transplant recipients underwent (99m)Tc-DTPA-- clearance measurement. Simultaneously, MDRD estimates were calculated and Cys C serum levels were determined. ROC analyses were performed at different decision points from 20 to 70 mL/min/1.73 m(2). RESULTS: Although the area under the curve did not differ significantly between MDRD and Cys C within the tested GFR range, the AUC for Cys C tended to be higher when GFR exceeded 55 mL/min/1.73 m(2). A significantly higher diagnostic accuracy for Cys C compared with MDRD (p = 0.045 at 65 mL/min/1.73 m(2)) was found when investigating the subgroup of patients with well-functioning grafts (GFR>40 mL/min/1.73 m(2)). CONCLUSION: MDRD equation is equivalent to Cys C measurement in renal transplant recipients. As availability of MDRD is superior to Cys C, we recommend GFR estimation using the MDRD equation. Nevertheless, Cys C may serve as a confirmation test of high MDRD estimates in patients with well-functioning grafts because of superior accuracy in these patients. SN - 0902-0063 UR - https://www.unboundmedicine.com/medline/citation/16640527/Prediction_of_glomerular_filtration_rate_in_renal_transplant_recipients:_cystatin_C_or_modification_of_diet_in_renal_disease_equation L2 - https://doi.org/10.1111/j.1399-0012.2005.00466.x DB - PRIME DP - Unbound Medicine ER -