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Kidney function estimating equations in patients with chronic kidney disease.
Int J Clin Pract. 2011 Apr; 65(4):458-64.IJ

Abstract

BACKGROUND

The current guidelines emphasise the need to assess kidney function using predictive equations rather than just serum creatinine. The present study compares serum cystatin C-based equations and serum creatinine-based equations in patients with chronic kidney disease (CKD).

METHODS

Seven hundred and sixty-four adult patients with CKD were enrolled. In each patient serum creatinine and serum cystatin C were determined. Their glomerular filtration rate (GFR) was estimated using three serum creatinine-based equations [Cockcroft-Gault (C&G), modification of diet in renal disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI)] and two serum cystatin C-based equations [our own cystatin C formula (GFR=90.63 × cystatin C(-1.192)) and simple cystatin C formula (GFR=100/cystatin C)]. The GFR was measured using (51) CrEDTA clearance.

RESULTS

Statistically significant correlation between (51) CrEDTA clearance with serum creatinine, serum cystatin C and all observed formulas was found. The receiver operating characteristic curve analysis (cut-off for GFR 60 ml/min/1.73m(2)) showed that serum cystatin C and both cystatin C formulas had a higher diagnostic accuracy than C&G formula. Bland and Altman analysis for the same cut-off value showed that all formulas except simple cystatin C formula underestimated measured GFR. The accuracy within 30% of estimated (51) CrEDTA clearance values differs according to stages of CKD. Analysis of ability to correctly predict patient's GFR below or above 60 ml/min/1.73m(2) showed statistically significant higher ability for both cystatin C formulas compared to MDRD formula.

CONCLUSION

Our results indicate that serum cystatin C-based equations are reliable markers of GFR comparable with creatinine-based formulas.

Authors+Show Affiliations

Department of Nephrology, Clinic of Internal Medicine, University Medical center Maribor, Maribor, Slovenia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21401834

Citation

Hojs, R, et al. "Kidney Function Estimating Equations in Patients With Chronic Kidney Disease." International Journal of Clinical Practice, vol. 65, no. 4, 2011, pp. 458-64.
Hojs R, Bevc S, Ekart R, et al. Kidney function estimating equations in patients with chronic kidney disease. Int J Clin Pract. 2011;65(4):458-64.
Hojs, R., Bevc, S., Ekart, R., Gorenjak, M., & Puklavec, L. (2011). Kidney function estimating equations in patients with chronic kidney disease. International Journal of Clinical Practice, 65(4), 458-64. https://doi.org/10.1111/j.1742-1241.2010.02597.x
Hojs R, et al. Kidney Function Estimating Equations in Patients With Chronic Kidney Disease. Int J Clin Pract. 2011;65(4):458-64. PubMed PMID: 21401834.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kidney function estimating equations in patients with chronic kidney disease. AU - Hojs,R, AU - Bevc,S, AU - Ekart,R, AU - Gorenjak,M, AU - Puklavec,L, PY - 2011/3/16/entrez PY - 2011/3/16/pubmed PY - 2011/12/23/medline SP - 458 EP - 64 JF - International journal of clinical practice JO - Int J Clin Pract VL - 65 IS - 4 N2 - BACKGROUND: The current guidelines emphasise the need to assess kidney function using predictive equations rather than just serum creatinine. The present study compares serum cystatin C-based equations and serum creatinine-based equations in patients with chronic kidney disease (CKD). METHODS: Seven hundred and sixty-four adult patients with CKD were enrolled. In each patient serum creatinine and serum cystatin C were determined. Their glomerular filtration rate (GFR) was estimated using three serum creatinine-based equations [Cockcroft-Gault (C&G), modification of diet in renal disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI)] and two serum cystatin C-based equations [our own cystatin C formula (GFR=90.63 × cystatin C(-1.192)) and simple cystatin C formula (GFR=100/cystatin C)]. The GFR was measured using (51) CrEDTA clearance. RESULTS: Statistically significant correlation between (51) CrEDTA clearance with serum creatinine, serum cystatin C and all observed formulas was found. The receiver operating characteristic curve analysis (cut-off for GFR 60 ml/min/1.73m(2)) showed that serum cystatin C and both cystatin C formulas had a higher diagnostic accuracy than C&G formula. Bland and Altman analysis for the same cut-off value showed that all formulas except simple cystatin C formula underestimated measured GFR. The accuracy within 30% of estimated (51) CrEDTA clearance values differs according to stages of CKD. Analysis of ability to correctly predict patient's GFR below or above 60 ml/min/1.73m(2) showed statistically significant higher ability for both cystatin C formulas compared to MDRD formula. CONCLUSION: Our results indicate that serum cystatin C-based equations are reliable markers of GFR comparable with creatinine-based formulas. SN - 1742-1241 UR - https://www.unboundmedicine.com/medline/citation/21401834/Kidney_function_estimating_equations_in_patients_with_chronic_kidney_disease_ L2 - https://doi.org/10.1111/j.1742-1241.2010.02597.x DB - PRIME DP - Unbound Medicine ER -