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Creatinine- vs. cystatin C-based equations compared with 99mTcDTPA scintigraphy to assess glomerular filtration rate in chronic kidney disease.
J Nephrol. 2012 Nov-Dec; 25(6):1003-15.JN

Abstract

BACKGROUND

In chronic kidney disease (CKD), accurate estimation of the glomerular filtration rate (GFR) is mandatory. Gold standard methods for its estimation are expensive and time-consuming. We compared creatinine- versus cystatin C-based equations to measure GFR, employing (99m)Tc-DTPA scintigraphy as the gold standard.

METHODS

This was a prospective cross-sectional observational study including 300 subjects. CKD was defined according to K/DOQI guidelines, and patients were separated into groups: stage 1 (G1), n=26; stage 2 (G2), n=52; stage 3 (G3), n=90; stage 4 (G4), n=37; stage 5 (G5), n=60; and control group, n=35. Creatinine-based estimates were from 24-hour creatinine clearance using the Walser formula, Cockcroft-Gault, MDRD-4 and CKD-EPI; cystatin C equations used were Larsson, Larsson modified equation, Grubb and Hoek.

RESULTS

Age and body mass index were different among groups; proteinuria, hypertension, diabetes and primary glomerulopathies significantly increased as CKD worsened. In the global assessment, CKD-EPI and Hoek gave the highest correlations with (99m)Tc-DTPA: rho=0.826, p<0.001 and rho=0.704, p<0.001, respectively. Most significant linear regressions obtained: CKD-EPI vs. (99m)Tc-DTPA, Hoek vs. (99m)Tc-DTPA and CKD-EPI vs. Hoek. However, important differences emerged when each group was analyzed separately. Best significant correlations obtained with (99m)Tc-DTPA: control group, creatinine clearance rho=0.421, p=0.012; G1, Crockoft-Gault rho=0.588, p=0.003; G2, CKD-EPI rho=0.462, p<0.05; G3, CKD-EPI rho=0.508, p<0.001; G4, Hoek rho=0.618, p<0.001; G5, CKD-EPI rho=0.604, p<0.001.

CONCLUSIONS

At GFR <60 ml/min, CKD-EPI and Hoek equations appeared to best correlate with (99m)TcDTPA. In controls and at early stages of CKD, creatinine-based equations correlated better with (99m)Tc-DTPA, with CKD-EPI being the one with the best degree of agreement.

Authors+Show Affiliations

Department of Nephrology, British Hospital of Buenos Aires, Buenos Aires, Argentina. htrimarchi@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22322818

Citation

Trimarchi, Hernán, et al. "Creatinine- Vs. Cystatin C-based Equations Compared With 99mTcDTPA Scintigraphy to Assess Glomerular Filtration Rate in Chronic Kidney Disease." Journal of Nephrology, vol. 25, no. 6, 2012, pp. 1003-15.
Trimarchi H, Muryan A, Martino D, et al. Creatinine- vs. cystatin C-based equations compared with 99mTcDTPA scintigraphy to assess glomerular filtration rate in chronic kidney disease. J Nephrol. 2012;25(6):1003-15.
Trimarchi, H., Muryan, A., Martino, D., Toscano, A., Iriarte, R., Campolo-Girard, V., Forrester, M., Pomeranz, V., Fitzsimons, C., Lombi, F., Young, P., Raña, M. S., & Alonso, M. (2012). Creatinine- vs. cystatin C-based equations compared with 99mTcDTPA scintigraphy to assess glomerular filtration rate in chronic kidney disease. Journal of Nephrology, 25(6), 1003-15. https://doi.org/10.5301/jn.5000083
Trimarchi H, et al. Creatinine- Vs. Cystatin C-based Equations Compared With 99mTcDTPA Scintigraphy to Assess Glomerular Filtration Rate in Chronic Kidney Disease. J Nephrol. 2012 Nov-Dec;25(6):1003-15. PubMed PMID: 22322818.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Creatinine- vs. cystatin C-based equations compared with 99mTcDTPA scintigraphy to assess glomerular filtration rate in chronic kidney disease. AU - Trimarchi,Hernán, AU - Muryan,Alexis, AU - Martino,Diana, AU - Toscano,Agostina, AU - Iriarte,Romina, AU - Campolo-Girard,Vicente, AU - Forrester,Mariano, AU - Pomeranz,Vanesa, AU - Fitzsimons,Clara, AU - Lombi,Fernando, AU - Young,Pablo, AU - Raña,María S, AU - Alonso,Mirta, PY - 2011/11/22/accepted PY - 2012/2/11/entrez PY - 2012/2/11/pubmed PY - 2013/5/7/medline SP - 1003 EP - 15 JF - Journal of nephrology JO - J Nephrol VL - 25 IS - 6 N2 - BACKGROUND: In chronic kidney disease (CKD), accurate estimation of the glomerular filtration rate (GFR) is mandatory. Gold standard methods for its estimation are expensive and time-consuming. We compared creatinine- versus cystatin C-based equations to measure GFR, employing (99m)Tc-DTPA scintigraphy as the gold standard. METHODS: This was a prospective cross-sectional observational study including 300 subjects. CKD was defined according to K/DOQI guidelines, and patients were separated into groups: stage 1 (G1), n=26; stage 2 (G2), n=52; stage 3 (G3), n=90; stage 4 (G4), n=37; stage 5 (G5), n=60; and control group, n=35. Creatinine-based estimates were from 24-hour creatinine clearance using the Walser formula, Cockcroft-Gault, MDRD-4 and CKD-EPI; cystatin C equations used were Larsson, Larsson modified equation, Grubb and Hoek. RESULTS: Age and body mass index were different among groups; proteinuria, hypertension, diabetes and primary glomerulopathies significantly increased as CKD worsened. In the global assessment, CKD-EPI and Hoek gave the highest correlations with (99m)Tc-DTPA: rho=0.826, p<0.001 and rho=0.704, p<0.001, respectively. Most significant linear regressions obtained: CKD-EPI vs. (99m)Tc-DTPA, Hoek vs. (99m)Tc-DTPA and CKD-EPI vs. Hoek. However, important differences emerged when each group was analyzed separately. Best significant correlations obtained with (99m)Tc-DTPA: control group, creatinine clearance rho=0.421, p=0.012; G1, Crockoft-Gault rho=0.588, p=0.003; G2, CKD-EPI rho=0.462, p<0.05; G3, CKD-EPI rho=0.508, p<0.001; G4, Hoek rho=0.618, p<0.001; G5, CKD-EPI rho=0.604, p<0.001. CONCLUSIONS: At GFR <60 ml/min, CKD-EPI and Hoek equations appeared to best correlate with (99m)TcDTPA. In controls and at early stages of CKD, creatinine-based equations correlated better with (99m)Tc-DTPA, with CKD-EPI being the one with the best degree of agreement. SN - 1724-6059 UR - https://www.unboundmedicine.com/medline/citation/22322818/Creatinine__vs__cystatin_C_based_equations_compared_with_99mTcDTPA_scintigraphy_to_assess_glomerular_filtration_rate_in_chronic_kidney_disease_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=22322818.ui DB - PRIME DP - Unbound Medicine ER -