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Application of creatinine- and/or cystatin C-based glomerular filtration rate estimation equations in elderly Chinese.
Clin Interv Aging. 2014; 9:1539-49.CI

Abstract

BACKGROUND

No conventional creatinine- or cystatin C-based glomerular filtration rate (GFR) estimation equation performed consistently outstandingly in elderly Chinese in our previous studies. This research aimed to further evaluate the performance of some recently proposed estimation equations based on creatinine and cystatin C, alone or combined, in this specific population.

MATERIALS AND METHODS

The equations were validated in a population totaling 419 participants (median age 68 [range 60-94] years). The estimated GFR (eGFR) calculated separately by ten equations was compared with the reference GFR (rGFR) measured by the (99m)Tc-DTPA renal dynamic imaging method.

RESULTS

Median serum creatinine, cystatin C, and rGFR levels were 0.93 mg/L, 1.13 mg/L, and 74.20 mL/min/1.73 m(2), respectively. The Chinese population-developed creatinine- and cystatin C-based (Cscr-cys) equation yielded the least median absolute difference (8.81 vs range 9.53-16.32, P<0.05, vs the Chronic Kidney Disease Epidemiology Collaboration serum creatinine equation), the highest proportion of eGFR within 15% and 30% of rGFR (P15 and P30, 55.13 and 85.44, P<0.05 and P<0.01, vs the Chronic Kidney Disease Epidemiology Collaboration serum creatinine equation), and the lowest root mean square error (14.87 vs range 15.30-22.45) in the whole cohort. A substantial agreement of diagnostic consistency between eGFR and rGFR (with a kappa 0.61-0.80) was also observed with the Cscr-cys equation. Moreover, measures of performance in the Cscr-cys equation were consistent across normal to mildly injured GFR strata and individuals aged ≤ 80 years. Among all the Cscr-cys equations, the elderly Chinese-developed creatinine-based (CEscr) equation performed best in this specific population. Nevertheless, none of the equations achieved ideal manifestation in the moderately to severely GFR-injured group or in individuals aged ≥ 80 years.

CONCLUSION

The Cscr-cys equation appeared to be optimal in elderly Chinese among the investigated equations. If cystatin C is not available, the CEscr equation is an acceptable alternative. A multicenter study with abundant subjects to develop an apposite formula for elderly Chinese is assumed to be essential.

Authors+Show Affiliations

Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.Division of Respiration, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.

Pub Type(s)

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

Language

eng

PubMed ID

25246780

Citation

Ye, Xiaoshuang, et al. "Application of Creatinine- And/or Cystatin C-based Glomerular Filtration Rate Estimation Equations in Elderly Chinese." Clinical Interventions in Aging, vol. 9, 2014, pp. 1539-49.
Ye X, Wei L, Pei X, et al. Application of creatinine- and/or cystatin C-based glomerular filtration rate estimation equations in elderly Chinese. Clin Interv Aging. 2014;9:1539-49.
Ye, X., Wei, L., Pei, X., Zhu, B., Wu, J., & Zhao, W. (2014). Application of creatinine- and/or cystatin C-based glomerular filtration rate estimation equations in elderly Chinese. Clinical Interventions in Aging, 9, 1539-49. https://doi.org/10.2147/CIA.S68801
Ye X, et al. Application of Creatinine- And/or Cystatin C-based Glomerular Filtration Rate Estimation Equations in Elderly Chinese. Clin Interv Aging. 2014;9:1539-49. PubMed PMID: 25246780.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Application of creatinine- and/or cystatin C-based glomerular filtration rate estimation equations in elderly Chinese. AU - Ye,Xiaoshuang, AU - Wei,Lu, AU - Pei,Xiaohua, AU - Zhu,Bei, AU - Wu,Jianqing, AU - Zhao,Weihong, Y1 - 2014/09/11/ PY - 2014/9/24/entrez PY - 2014/9/24/pubmed PY - 2015/5/13/medline KW - creatinine KW - cystatin C KW - elderly Chinese KW - equation KW - glomerular filtration rate SP - 1539 EP - 49 JF - Clinical interventions in aging JO - Clin Interv Aging VL - 9 N2 - BACKGROUND: No conventional creatinine- or cystatin C-based glomerular filtration rate (GFR) estimation equation performed consistently outstandingly in elderly Chinese in our previous studies. This research aimed to further evaluate the performance of some recently proposed estimation equations based on creatinine and cystatin C, alone or combined, in this specific population. MATERIALS AND METHODS: The equations were validated in a population totaling 419 participants (median age 68 [range 60-94] years). The estimated GFR (eGFR) calculated separately by ten equations was compared with the reference GFR (rGFR) measured by the (99m)Tc-DTPA renal dynamic imaging method. RESULTS: Median serum creatinine, cystatin C, and rGFR levels were 0.93 mg/L, 1.13 mg/L, and 74.20 mL/min/1.73 m(2), respectively. The Chinese population-developed creatinine- and cystatin C-based (Cscr-cys) equation yielded the least median absolute difference (8.81 vs range 9.53-16.32, P<0.05, vs the Chronic Kidney Disease Epidemiology Collaboration serum creatinine equation), the highest proportion of eGFR within 15% and 30% of rGFR (P15 and P30, 55.13 and 85.44, P<0.05 and P<0.01, vs the Chronic Kidney Disease Epidemiology Collaboration serum creatinine equation), and the lowest root mean square error (14.87 vs range 15.30-22.45) in the whole cohort. A substantial agreement of diagnostic consistency between eGFR and rGFR (with a kappa 0.61-0.80) was also observed with the Cscr-cys equation. Moreover, measures of performance in the Cscr-cys equation were consistent across normal to mildly injured GFR strata and individuals aged ≤ 80 years. Among all the Cscr-cys equations, the elderly Chinese-developed creatinine-based (CEscr) equation performed best in this specific population. Nevertheless, none of the equations achieved ideal manifestation in the moderately to severely GFR-injured group or in individuals aged ≥ 80 years. CONCLUSION: The Cscr-cys equation appeared to be optimal in elderly Chinese among the investigated equations. If cystatin C is not available, the CEscr equation is an acceptable alternative. A multicenter study with abundant subjects to develop an apposite formula for elderly Chinese is assumed to be essential. SN - 1178-1998 UR - https://www.unboundmedicine.com/medline/citation/25246780/Application_of_creatinine__and/or_cystatin_C_based_glomerular_filtration_rate_estimation_equations_in_elderly_Chinese_ L2 - https://dx.doi.org/10.2147/CIA.S68801 DB - PRIME DP - Unbound Medicine ER -