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Assessment of creatinine and cystatin C-based eGFR equations in Chinese older adults with chronic kidney disease.
Int Urol Nephrol. 2018 Dec; 50(12):2229-2238.IU

Abstract

INTRODUCTION

Glomerular filtration rate (GFR) estimation equations using creatinine and Cystatin-C appear to be superior to those based on creatinine or Cystatin-C in older adults. We sought to compare the performances of those based on creatinine and Cystatin-C in Chinese older adults with chronic kidney disease (CKD).

METHODS

A total of 368 Chinese elderly with CKD underwent the dynamic imaging with technetium-99m diethylene-triamine-pentaacetic acid (99mTc-DTPA), and serum creatinine and Cystatin-C were measured on the same day. The comparison of GFR equations which were creatinine and Cystatin-C-based including chronic kidney disease epidemiology collaboration (CKD-EPI) equation (CKD-EPI-Cr-Cys), Berlin Initiative Study (BIS) equation (BIS-Cr-Cys, also known as BIS-2), MA equation (MA-Cr-Cys), and FENG equation (FENG-Cr-Cys) was conducted.

RESULTS

Four equations overestimated GFR except for BIS-2 equation in mGFR ≥ 60 ml/min/1.73 m2 (bias: - 1.40, p = 0.7) and CKD-EPI-Cr-Cys equation in mGFR < 30 ml/min/1.73 m2 (bias: - 1.82, p = 0.2) were unbiased. BIS-2 equation had the smallest interquartile range (IQR, ml/min/1.73 m2) from 12.73 in age < 75 years group to 16.05 in age ≥ 75 years group. BIS-2 equation achieved highest values of 79.1% in overall participants, and 80.77% in age ≥ 75 years group, respectively, and CKD-EPI-Cr-Cys equation 82.26% in age < 75 years group. Lowest values of root-mean-square error (RMSE, ml/min/1.73 m2) were seen in BIS-2 equation from 13.22 in age < 75 years group to 16.18 in age ≥ 75 years group. BIS-2 equation had the lowest misclassification rates of 41.76% in age ≥ 75 years group and 34.41% in age < 75 years group.

CONCLUSIONS

BIS-2 equation may be optimal for Chinese older adults with CKD especially in older adults ≥ 75 years and with mGFR ≥ 30 ml/min/1.73 m2, while CKD-EPI-Cr-Cys equation could yield a better performance than BIS-2 equation, especially in those < 75 years and mGFR < 30 ml/min/1.73 m2.

Authors+Show Affiliations

Department of Nephrology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, 510180, China.Department of Nephrology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, 510180, China.Department of Nephrology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, 510180, China.Department of Nephrology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, 510180, China.Department of Nephrology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, 510180, China.Department of Nephrology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, 510180, China.Department of Nuclear Medicine, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, 510180, China.Department of Clinical Laboratory Medicine, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, 510180, China.Department of Nephrology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, 510180, China. fujzhou@163.com.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

29948865

Citation

Guan, Changjie, et al. "Assessment of Creatinine and Cystatin C-based eGFR Equations in Chinese Older Adults With Chronic Kidney Disease." International Urology and Nephrology, vol. 50, no. 12, 2018, pp. 2229-2238.
Guan C, Liang M, Liu R, et al. Assessment of creatinine and cystatin C-based eGFR equations in Chinese older adults with chronic kidney disease. Int Urol Nephrol. 2018;50(12):2229-2238.
Guan, C., Liang, M., Liu, R., Qin, S., He, F., Li, J., Zhu, X., Dai, H., & Fu, J. (2018). Assessment of creatinine and cystatin C-based eGFR equations in Chinese older adults with chronic kidney disease. International Urology and Nephrology, 50(12), 2229-2238. https://doi.org/10.1007/s11255-018-1909-7
Guan C, et al. Assessment of Creatinine and Cystatin C-based eGFR Equations in Chinese Older Adults With Chronic Kidney Disease. Int Urol Nephrol. 2018;50(12):2229-2238. PubMed PMID: 29948865.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of creatinine and cystatin C-based eGFR equations in Chinese older adults with chronic kidney disease. AU - Guan,Changjie, AU - Liang,Ming, AU - Liu,Riguang, AU - Qin,Shuguang, AU - He,Feng, AU - Li,Jianwen, AU - Zhu,Xusheng, AU - Dai,Hui, AU - Fu,Junzhou, Y1 - 2018/06/13/ PY - 2018/02/27/received PY - 2018/06/06/accepted PY - 2018/6/28/pubmed PY - 2019/4/9/medline PY - 2018/6/28/entrez KW - Chronic kidney disease KW - Creatinine KW - Cystatin-C KW - Equation KW - Glomerular filtration rate KW - Older adults SP - 2229 EP - 2238 JF - International urology and nephrology JO - Int Urol Nephrol VL - 50 IS - 12 N2 - INTRODUCTION: Glomerular filtration rate (GFR) estimation equations using creatinine and Cystatin-C appear to be superior to those based on creatinine or Cystatin-C in older adults. We sought to compare the performances of those based on creatinine and Cystatin-C in Chinese older adults with chronic kidney disease (CKD). METHODS: A total of 368 Chinese elderly with CKD underwent the dynamic imaging with technetium-99m diethylene-triamine-pentaacetic acid (99mTc-DTPA), and serum creatinine and Cystatin-C were measured on the same day. The comparison of GFR equations which were creatinine and Cystatin-C-based including chronic kidney disease epidemiology collaboration (CKD-EPI) equation (CKD-EPI-Cr-Cys), Berlin Initiative Study (BIS) equation (BIS-Cr-Cys, also known as BIS-2), MA equation (MA-Cr-Cys), and FENG equation (FENG-Cr-Cys) was conducted. RESULTS: Four equations overestimated GFR except for BIS-2 equation in mGFR ≥ 60 ml/min/1.73 m2 (bias: - 1.40, p = 0.7) and CKD-EPI-Cr-Cys equation in mGFR < 30 ml/min/1.73 m2 (bias: - 1.82, p = 0.2) were unbiased. BIS-2 equation had the smallest interquartile range (IQR, ml/min/1.73 m2) from 12.73 in age < 75 years group to 16.05 in age ≥ 75 years group. BIS-2 equation achieved highest values of 79.1% in overall participants, and 80.77% in age ≥ 75 years group, respectively, and CKD-EPI-Cr-Cys equation 82.26% in age < 75 years group. Lowest values of root-mean-square error (RMSE, ml/min/1.73 m2) were seen in BIS-2 equation from 13.22 in age < 75 years group to 16.18 in age ≥ 75 years group. BIS-2 equation had the lowest misclassification rates of 41.76% in age ≥ 75 years group and 34.41% in age < 75 years group. CONCLUSIONS: BIS-2 equation may be optimal for Chinese older adults with CKD especially in older adults ≥ 75 years and with mGFR ≥ 30 ml/min/1.73 m2, while CKD-EPI-Cr-Cys equation could yield a better performance than BIS-2 equation, especially in those < 75 years and mGFR < 30 ml/min/1.73 m2. SN - 1573-2584 UR - https://www.unboundmedicine.com/medline/citation/29948865/Assessment_of_creatinine_and_cystatin_C_based_eGFR_equations_in_Chinese_older_adults_with_chronic_kidney_disease_ L2 - https://doi.org/10.1007/s11255-018-1909-7 DB - PRIME DP - Unbound Medicine ER -