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Kidney function estimating equations in patients with chronic kidney disease
Hojs, Radovan ...
Background: The current guidelines emphasise the need to assess kidney function using predictive equations rather than just serum creatinine. The present study compares serum cystatin C-based ...equations and serum creatinine-based equations in patients with chronic kidney disease (CKD). Methods: Seven hundred and sixty-four adult patients with CKD were enrolled. In each patient serum creatinine and serum cystatin C were determined. Their glomerular filtration rate (GFR) was estimated using three serum creatinine-based equations [Cockcroft-Gault (C&G), modification of diet in renal disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI)] and two serum cystatin C-based equations [our own cystatin C formula (GFR = 90.63 x cystatin C(-1.192) ) and simple cystatin C formula (GFR = 100/cystatin C)]. The GFR was measured using (51) CrEDTA clearance. Results: Statistically significant correlation between (51) CrEDTA clearance with serum creatinine, serum cystatin C and all observed formulas was found. The receiver operating characteristic curve analysis (cut-off for GFR 60 ml/min/1.73 m(2) ) showed that serum cystatin C and both cystatin C formulas had a higher diagnostic accuracy than C&G formula. Bland and Altman analysis for the same cut-off value showed that all formulas except simple cystatin C formula under estimated measured GFR. The accuracy within 30% of estimated (51) CrEDTA clearance values differs according to stages of CKD. Analysis of ability to correctly predict patient's GFR below or above 60 ml/min/1.73 m(2) showed statistically significant higher ability for both cystatin C formulas compared to MDRD formula. Conclusion: Our results indicate that serum cystatin C-based equations are reliable markers of GFR comparable with creatinine-based formulas.
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