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Estimating glomerular filtration rate by serum creatinine or/and cystatin C equations: An analysis of multi-centre Chinese subjects.
Nephrology (Carlton). 2016 May; 21(5):372-8.N

Abstract

AIM

Various equations based on serum creatinine or/and cystatin C, required further validation in a Chinese population. We compared the performance of six Chinese equations (Mascr, Peiscr, Macys, Fengcys, Mascr-cys and Fengscr-cys) with the CKD-EPI equations in multi-centre Chinese subjects and evaluated their applicability in clinical practice.

METHODS

A total of 1522 adult patients from four different hospitals of China were enrolled in the study. (99m) Tc-DTPA renal dynamic imaging was used as the reference GFR (rGFR), and serum creatinine and cystatin C were measured by standardized assays. An optimal score system was implemented in the study.

RESULTS

The average rGFR of recruited subjects was 67.30±28.89 mL/min per 1.73m(2) . All estimated GFR (eGFR) correlated well with rGFR. In accordance with Bland-Altman analysis, the Fengscr-cys equations achieved optimal overall performance (score 14 vs 0-6), with least bias (median difference, -0.57 mL/min per 1.73m(2) ; median absolute difference, 8.83 mL/min per 1.73m(2)), best precision (17.99 mL/min per 1.73m(2)), highest accuracy (percentage of eGFR within 15%, 30% and 50% of the rGFR (P15 , P30 and P50 ; 49.7%, 78.7% and 91.8%, respectively); root-mean-square-error (RMSE, 16.28)). The Fengcys equation, a typical cystatin C based equation, was another well-behaved formula with an impressive performance. The Ma equations performed much poorer than the CKD-EPI equations. Consistent results can be observed in the GFR- /age- and sex-specific subgroups, while none equation yielded ideal accuracy in GFR<60 mL/min per 1.73 m(2) subgroup.

CONCLUSION

The Fengscr-cys equation appeared to achieve the best performance for GFR estimation in overall Chinese adult patients. However, further research is warranted to improve the accuracy of available equations in GFR less than 60 mL/min per 1.73 m(2) individuals.

Authors+Show Affiliations

Department of Nephrology, Jiangsu Geriatric Hospital, Nanjing, Jiangsu, China. Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.Division of Nephrology, Department of Internal Medicine, The Third Affiliated hospital of sun Yat-sen University, Guangzhou, China.Department of Nephrology, The Second Affiliated hospital of Wuxi Hospital, Nanjing Medical University, Wuxi, China.Department of Nephrology, The FAW General Hospital, The Fourth Affiliated hospital of JiLin University, Changchun, China.Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.Division of Respiration, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.Division of Nephrology, Department of Internal Medicine, The Third Affiliated hospital of sun Yat-sen University, Guangzhou, China.Department of Nephrology, Jiangsu Geriatric Hospital, Nanjing, Jiangsu, China.

Pub Type(s)

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

Language

eng

PubMed ID

26427030

Citation

Ye, Xiaoshuang, et al. "Estimating Glomerular Filtration Rate By Serum Creatinine Or/and Cystatin C Equations: an Analysis of Multi-centre Chinese Subjects." Nephrology (Carlton, Vic.), vol. 21, no. 5, 2016, pp. 372-8.
Ye X, Liu X, Song D, et al. Estimating glomerular filtration rate by serum creatinine or/and cystatin C equations: An analysis of multi-centre Chinese subjects. Nephrology (Carlton). 2016;21(5):372-8.
Ye, X., Liu, X., Song, D., Zhang, X., Zhu, B., Wei, L., Pei, X., Wu, J., Lou, T., & Zhao, W. (2016). Estimating glomerular filtration rate by serum creatinine or/and cystatin C equations: An analysis of multi-centre Chinese subjects. Nephrology (Carlton, Vic.), 21(5), 372-8. https://doi.org/10.1111/nep.12636
Ye X, et al. Estimating Glomerular Filtration Rate By Serum Creatinine Or/and Cystatin C Equations: an Analysis of Multi-centre Chinese Subjects. Nephrology (Carlton). 2016;21(5):372-8. PubMed PMID: 26427030.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Estimating glomerular filtration rate by serum creatinine or/and cystatin C equations: An analysis of multi-centre Chinese subjects. AU - Ye,Xiaoshuang, AU - Liu,Xun, AU - Song,Dan, AU - Zhang,Xiaoxuan, AU - Zhu,Bei, AU - Wei,Lu, AU - Pei,Xiaohua, AU - Wu,Jianqing, AU - Lou,Tanqi, AU - Zhao,Weihong, PY - 2015/01/28/received PY - 2015/08/31/revised PY - 2015/09/28/accepted PY - 2015/10/2/entrez PY - 2015/10/2/pubmed PY - 2017/1/18/medline KW - CKD-EPI KW - Chinese KW - cystatin C KW - equation KW - glomerular filtration rate KW - serum creatinine SP - 372 EP - 8 JF - Nephrology (Carlton, Vic.) JO - Nephrology (Carlton) VL - 21 IS - 5 N2 - AIM: Various equations based on serum creatinine or/and cystatin C, required further validation in a Chinese population. We compared the performance of six Chinese equations (Mascr, Peiscr, Macys, Fengcys, Mascr-cys and Fengscr-cys) with the CKD-EPI equations in multi-centre Chinese subjects and evaluated their applicability in clinical practice. METHODS: A total of 1522 adult patients from four different hospitals of China were enrolled in the study. (99m) Tc-DTPA renal dynamic imaging was used as the reference GFR (rGFR), and serum creatinine and cystatin C were measured by standardized assays. An optimal score system was implemented in the study. RESULTS: The average rGFR of recruited subjects was 67.30±28.89 mL/min per 1.73m(2) . All estimated GFR (eGFR) correlated well with rGFR. In accordance with Bland-Altman analysis, the Fengscr-cys equations achieved optimal overall performance (score 14 vs 0-6), with least bias (median difference, -0.57 mL/min per 1.73m(2) ; median absolute difference, 8.83 mL/min per 1.73m(2)), best precision (17.99 mL/min per 1.73m(2)), highest accuracy (percentage of eGFR within 15%, 30% and 50% of the rGFR (P15 , P30 and P50 ; 49.7%, 78.7% and 91.8%, respectively); root-mean-square-error (RMSE, 16.28)). The Fengcys equation, a typical cystatin C based equation, was another well-behaved formula with an impressive performance. The Ma equations performed much poorer than the CKD-EPI equations. Consistent results can be observed in the GFR- /age- and sex-specific subgroups, while none equation yielded ideal accuracy in GFR<60 mL/min per 1.73 m(2) subgroup. CONCLUSION: The Fengscr-cys equation appeared to achieve the best performance for GFR estimation in overall Chinese adult patients. However, further research is warranted to improve the accuracy of available equations in GFR less than 60 mL/min per 1.73 m(2) individuals. SN - 1440-1797 UR - https://www.unboundmedicine.com/medline/citation/26427030/Estimating_glomerular_filtration_rate_by_serum_creatinine_or/and_cystatin_C_equations:_An_analysis_of_multi_centre_Chinese_subjects_ DB - PRIME DP - Unbound Medicine ER -