Performance of the CKD-EPI creatinine-cystatin C glomerular filtration rate estimation equations in a multiethnic Asian population.
- Author:
Boon Wee TEO
1
;
Yun Yin KOH
;
Qi Chun TOH
;
Jialiang LI
;
Arvind Kumar SINHA
;
Borys SHUTER
;
Sunil SETHI
;
Evan J C LEE
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Biomarkers; blood; urine; China; ethnology; Creatinine; blood; Cystatin C; blood; Female; Glomerular Filtration Rate; Healthy Volunteers; Humans; India; ethnology; Malaysia; ethnology; Male; Middle Aged; Models, Statistical; Prospective Studies; Renal Insufficiency, Chronic; blood; urine; Reproducibility of Results
- From:Singapore medical journal 2014;55(12):656-659
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONClinical practice guidelines recommend using creatinine-based equations to estimate glomerular filtration rates (GFRs). While these equations were formulated for Caucasian-American populations and have adjustment coefficients for African-American populations, they are not validated for other ethnicities. The Chronic Kidney Disease-Epidemiology Collaborative Group (CKD-EPI) recently developed a new equation that uses both creatinine and cystatin C. We aimed to assess the accuracy of this equation in estimating the GFRs of participants (healthy and with chronic kidney disease [CKD]) from a multiethnic Asian population.
METHODSSerum samples from the Asian Kidney Disease Study and the Singapore Kidney Function Study were used. GFR was measured using plasma clearance of 99mTc-DTPA. GFR was estimated using the CKD-EPI equations. The performance of GFR estimation equations were examined using median and interquartile range values, and the percentage difference from the measured GFR.
RESULTSThe study comprised 335 participants (69.3% with CKD; 38.5% Chinese, 29.6% Malays, 23.6% Indians, 8.3% others), with a mean age of 53.5 ± 15.1 years. Mean standardised serum creatinine was 127 ± 86 μmol/L, while mean standardised serum cystatin C and mean measured GFR were 1.43 ± 0.74 mg/L and 67 ± 33 mL/min/1.73 m2, respectively. The creatinine-cystatin C CKD-EPI equation performed the best, with an estimated GFR of 67 ± 35 mL/min/1.73 m2.
CONCLUSIONThe new creatinine-cystatin C equation estimated GFR with little bias, and had increased precision and accuracy in our multiethnic Asian population. This two-biomarker equation may increase the accuracy of population studies on CKD, without the need to consider ethnicity.