scholarly journals Evaluation of Renal Function in Obese Children and Adolescents Using Serum Cystatin C Levels, Estimated Glomerular Filtration Rate Formulae and Proteinuria: Which is most Useful?

Author(s):  
Dilşah Önerli Salman ◽  
Zeynep Şıklar ◽  
Eda Nisa Çullas İlarslan ◽  
Z. Birsin Özçakar ◽  
Pınar Kocaay ◽  
...  
2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Inés Lujambio ◽  
Mariana Sottolano ◽  
Leonella Luzardo ◽  
Sebastián Robaina ◽  
Nadia Krul ◽  
...  

Background. Estimation of glomerular filtration rate (eGFR) from biomarkers has evolved and multiple equations are available to estimate renal function at bedside.Methods. In a random sample of 119 Uruguayans (54.5% women; 56.2 years (mean)), we used Bland and Altman’s method and Cohen’s kappa statistic to assess concordance on a continuous or categorical (eGFR < 60versus≥60 mL/min/1.73 m2) scale between eGFRcys(reference) and eGFR derived from serum creatinine according to the Modification of Diet in Renal Disease (eGFRmdrd) or the Chronic Kidney Disease Epidemiology Collaboration equations (eGFRepi) or from both serum cystatin C and creatinine (eGFRmix).Results. In all participants, eGFRmdrd, eGFRepi, and eGFRmixwere, respectively, 9.7, 11.5, and 5.6 mL/min/1.73 m2higher (P<0.0001) than eGFRcys. The prevalence of eGFR <60 mL/min/1.73 m2was the highest for eGFRcys(21.8%), intermediate for eGFRmix(11.8%), and the lowest for eGFRmdrd(5.9%) and eGFRepi(3.4%). Using eGFRcysas reference, we found only fair agreement with the equations based on creatinine (Cohen’s kappa statistic 0.15 to 0.23).Conclusion. Using different equations we reached clinically significant differences in the estimation of renal function. eGFRcysprovides lower estimates, resulting in higher prevalence of eGFR <60 mL/min/1.73 m2.


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