Effect of creatinine and cystatin C measurement variations on calculated estimated glomerular filtration rate variations and the theoretical impact on kidney disease stage classification: A retrospective study

2018 ◽  
Vol 477 ◽  
pp. 13-17
Author(s):  
Dae-Hyun Ko ◽  
Sung Woo Lee ◽  
Jungwon Hyun ◽  
Hyun Soo Kim ◽  
Min-Jeong Park ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Retrospective Study ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Disease Stage ◽  
Stage Classification

scholarly journals Comparison of seven estimated glomerular filtration rate equations in kidney patients

2013 ◽  
Vol 154 (11) ◽  
pp. 415-425
Author(s):  
Ferenc Kovács ◽  
Enikő Sárváry ◽  
Ádám Remport
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Rate Equations

Introduction: The degree of glomerular filtration rate determines the stages of chronic renal disease and, therefore, knowledge on its estimation is essential. Aims: Two standardized creatinine based estimated glomerular filtration rate equations and five equations based on the immunoturbidimetric determination of cystatin C were compared. Methods: The distribution of the analytes and the equations, their relations, as well as the differences among the estimated glomerular filtration rates and their chronic kidney disease stages assignments were studied. Results: The equations based on cystatin C classified more patient into stage 1, while the creatinine based ones more into stages 2, 3 and 4. The equations published as Grubb1, Grubb2 and Larsson classified more patients while the equations created by Tan and Sjöström classified fewer into stage 5 compared to the creatinine based equations. The equations of Grubb1 and Grubb2 resulted in the most similar stage assignment. The occurence of stages between 3 and 5 was the lowest using the equation of Sjöström. Conclusions: The different equations for the estimation of glomerular filtration rate modify significantly the chronic kidney disease stage assignment which may have an influence on the treatment and outcome measures of the patients. Orv. Hetil., 2013, 154, 415–425.

Abstract 13357: Cystatin C Based Estimated Glomerular Filtration Rate (eGFR) Predicts Adverse Clinical Outcomes More Effectively Than Creatinine Based eGFR in Patients With Peripheral Artery Disease

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Otaki Yoichiro ◽  
Tetsu Watanabe ◽  
Hiroki Takahashi ◽  
Gensai Yamaura ◽  
Takanori Arimoto ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Peripheral Artery Disease ◽  
Cystatin C ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Disease Stage ◽  
Peripheral Artery ◽  
Artery Disease

Introduction: Kidney dysfunction is reported to be associated with adverse outcome in patients with peripheral artery disease (PAD). Estimated glomerular filtration rate (eGFR), which is recently-popularized index for assessing kidney function, is calculated using serum creatinine or cystatin C level. Cystatin C based eGFR (eGFRcys) is less affected by age, gender, and muscle mass compared to creatinine based eGFR (eGFRcr). Hypothesis: We hypothesized that eGFRcys is a feasible prognostic parameter despite muscle sarcopenia in patients with PAD. Methods: We calculated both eGFRcr and eGFRcys according to kidney disease improving global outcomes (KDIGO) guideline in 235 PAD patients who underwent endovascular therapy. Patients were prospectively followed during a median follow up period of 618 days, with the end points of major adverse cardiovascular and cerebrovascular events (MACCE). Results: A multivariate Cox proportional hazard analysis revealed that eGFRcys, but not eGFRcr, was an independent predictor of MACCE. The C index was larger for eGFRcys than eGFRcr (0.70 versus 0.61; P=0.0071). Kaplan-Meier analysis demonstrated that incidence of MACCE was increased with advancing chronic kidney disease stage based on eGFRcys, but not eGFRcr, in patients with PAD. Net reclassification index was improved by addition of eGFRcys to basic predictors. Conclusions: eGFRcys could be a reliable marker for MACCE and risk stratify patients at high risk more effectively than eGFRcr in patients with PAD.

scholarly journals Performance of Cystatin C– and Creatinine-Based Estimated Glomerular Filtration Rate Equations Depends on Patient Characteristics

2015 ◽  
Vol 61 (10) ◽  
pp. 1265-1272 ◽  
Author(s):  
Jeffrey W Meeusen ◽  
Andrew D Rule ◽  
Nikolay Voskoboev ◽  
Nikola A Baumann ◽  
John C Lieske
Keyword(s):  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Patient Characteristics ◽  
Transplant Recipients ◽  
Ckd Stage ◽  
Measured Gfr

Abstract BACKGROUND The Kidney Disease Improving Global Outcomes (KDIGO) guideline recommends use of a cystatin C–based estimated glomerular filtration rate (eGFR) to confirm creatinine-based eGFR between 45 and 59 mL · min−1 · (1.73 m2)−1. Prior studies have demonstrated that comorbidities such as solid-organ transplant strongly influence the relationship between measured GFR, creatinine, and cystatin C. Our objective was to evaluate the performance of cystatin C–based eGFR equations compared with creatinine-based eGFR and measured GFR across different clinical presentations. METHODS We compared the performance of the CKD-EPI 2009 creatinine-based estimated GFR equation (eGFRCr) and the newer CKD-EPI 2012 cystatin C–based equations (eGFRCys and eGFRCr-Cys) with measured GFR (iothalamate renal clearance) across defined patient populations. Patients (n = 1652) were categorized as transplant recipients (n = 568 kidney; n = 319 other organ), known chronic kidney disease (CKD) patients (n = 618), or potential kidney donors (n = 147). RESULTS eGFRCr-Cys showed the most consistent performance across different clinical populations. Among potential kidney donors without CKD [stage 2 or higher; eGFR >60 mL · min−1 · (1.73 m2)−1], eGFRCys and eGFRCr-Cys demonstrated significantly less bias than eGFRCr; however, all 3 equations substantially underestimated GFR when eGFR was <60 mL · min−1 · (1.73 m2)−1. Among transplant recipients with CKD stage 3B or greater [eGFR <45 mL · min−1 · (1.73 m2)−1], eGFRCys was significantly more biased than eGFRCr. No clear differences in eGFR bias between equations were observed among known CKD patients regardless of eGFR range or in any patient group with a GFR between 45 and 59 mL · min−1 · (1.73 m2)−1. CONCLUSIONS The performance of eGFR equations depends on patient characteristics that are readily apparent on presentation. Among the 3 CKD-EPI equations, eGFRCr-Cys performed most consistently across the studied patient populations.

scholarly journals Comparison of Performance of Equations for Estimated Glomerular Filtration Rate in Chinese Patients with Biopsy-Proven Diabetic Nephropathy

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Yiting Wang ◽  
Junlin Zhang ◽  
Geer Teng ◽  
Yucheng Wu ◽  
Qianqian Han ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Diabetic Nephropathy ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Chinese Patients ◽  
Multivariable Logistic Regression

Background. The performance of various equations for estimated glomerular filtration rate (eGFR) in patients with diabetes remains controversial. We aimed to evaluate the performance of equations for eGFR in Chinese patients with diabetic nephropathy (DN). Methods. This is a retrospective study included in 308 patients with type 2 diabetes and biopsy-proven DN who were followed up at least one year. eGFR was calculated using chronic kidney disease epidemiology (CKD-EPI) equations based on serum creatinine (eGFRCKD-EPI-Cr), cystatin C (eGFRCKD-EPI-CysC), and joint equations (eGFRCKD-EPI-Cr-CysC), respectively. End-stage kidney disease was defined by initiation of renal replacement therapy. The eGFR concordance between equations was assessed by Bland-Altman plots. Log-rank and multivariable logistic regression were employed to evaluate the performance of equations. Results. Overall, the proportion of patients with eGFR<60 mL/min/1.73m2 was 53%, 70%, and 61% by the equations of eGFRCKD-EPI-Cr, eGFRCKD-EPI-CysC, and eGFRCKD-EPI-Cr-CysC, respectively. Higher disconcordance was observed between equations when eGFR>60 mL/min/1.73m2. Compared with eGFRCKD-EPI-Cr, 39% of patients were reclassified (reclassified group) from CKD 1-2 stages to CKD 3-5 stages by eGFRCKD-EPI-CysC and they presented significantly longer diabetic duration, heavier proteinuria, advanced pathological lesions, and poorer kidney outcomes. Multivariable logistic regression indicated cystatin C was independently associated with advanced glomerular classifications. Conclusion. eGFR equations incorporating cystatin C are superior to eGFR based on creatinine alone for detecting kidney injury in the early stage. The independent association between cystatin C and glomerular classifications might contribute to it.

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