e-journal

Simple Cystatin C Formula Compared to SophisticatedCKD-EPI Formulas for Estimation of Glomerular Filtration Rate in the Elderly

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Abstract: Despite the fact that the serum creatinine level is notoriously unreliable for the estimation of glomerular filtration rate (GFR) in the elderly, the serum creatinine concentration
and serum creatinine-based formulas, such as the Modification of Diet in Renal Disease study equation (MDRD) are the most commonly used markers to estimate GFR.Recently, serum cystatin C-based formulas, the newer creatinine formula (the Chronic Kidney Disease Epidemiology
Collaboration formula (CKD-EPI creatinine formula), and an equation that uses both serum creatinine
and cystatin C (CKD-EPI creatinine and cystatin formula) were proposed as new GFR markers.The aim of our study was to compare the MDRD formula, CKD-EPI creatinine formula, CKD-EPI creatinine and cystatin formula, and simple cystatin C formula (100/serum cystatin C) against 51Cr-EDTA clearance in the elderly. A total of 317 adult Caucasian patients aged >65 years were enrolled. In each
patient, 51Cr-EDTA clearance, serum creatinine, and serum cystatin C were determined, and the GFR was calculated using the MDRD formula, CKD-EPI formulas, and simple cystatin C formula. Statistically significant correlations between 51Cr-EDTA clearance and all formulas were found. In the receiver operating characteristic (ROC) curve analysis with a cut-off of GFR 45 mL/min/1.73 m2, a higher diagnostic accuracy was achieved with the equation that uses both serum creatinine and cystatin C (CKD-EPI creatinine and cystatin formula) than the MDRD formula (P < 0.013) or CKD-EPI creatinine formula (P < 0.01), but it was not higher than that achieved for the simple cystatin C formula (P = 0.335). Bland and Altman analysis for the same cut-off value showed that the creatinine formulas underestimated and the simple cystatin C formula overestimated measured GFR. All equations lacked precision. The accuracy within 30% of estimated 51Cr-EDTA clearance
values differ according to the stage of CKD. Analysis of the ability to correctly predict GFR below and above 45 mL/min/1.73 m2 showed a high prediction for all formulas. Our results indicate that the simple cystatin C formula, which requires just one variable (serum cystatin Concentration ),is a reliable marker of GFR in the elderly andcomparable to the creatinine formulas, including the CKD-EPI formulas.

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Informasi Detail

Judul Seri

Therapeutic Apheresis and Dialysis

No. Panggil

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Penerbit

: Therapeutic Apheresis and Dialysis © 2011 International Society for Apheresis., 2011

Deskripsi Fisik

Therapeutic Apheresis and Dialysis 15(3):261–268, 2011

Bahasa

English

ISBN/ISSN

doi: 10.1111/j.1744-

Klasifikasi

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Tipe Isi

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Tipe Media

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Tipe Pembawa

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Edisi

15(3)

Subjek

Therapeutic Apheresis and Dialysis

Info Detail Spesifik

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Pernyataan Tanggungjawab

deliza

Versi lain/terkait

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