Comparison of glomerular filtration rates calculated by different serum cystatin C-based equations in patients with chronic kidney disease.
- Author:
Hee Sun LEE
1
;
Ha Rin RHEE
;
Eun Young SEONG
;
Dong Won LEE
;
Soo Bong LEE
;
Ihm Soo KWAK
Author Information
1. Department of Internal Medicine, Youngdo Hospital, Busan, Korea.
- Publication Type:Original Article
- Keywords:
Chronic kidneydisease;
Cystatin C;
Estimated glomerular filtration rate;
Serum creatinine
- MeSH:
Creatinine;
Cystatin C;
Diet;
Glomerular Filtration Rate*;
Humans;
Kidney Diseases;
Male;
Renal Insufficiency, Chronic*
- From:Kidney Research and Clinical Practice
2014;33(1):45-51
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: We aimed to evaluate the performance of serum cystatin C-based equations in calculating the glomerular filtration rate (GFR) in patients with varying stages of chronic kidney disease (CKD). METHODS: Serum cystatin C and creatinine levels were measured in 615 CKD patients. The CKD stage was determined by the creatinine-based estimated GFR (eGFR) equation using the four-variable abbreviated Modification of Diet in Renal Disease equation suggested by the Kidney Disease Outcome Quality Initiative with the addition of a coefficient applicable to Korean populations (K-aMDRD). In each CKD stage, the ratio of serum cystatin C to creatinine was calculated and six different cystatin C-based equations were used to estimate GFR. Cystatin C-based eGFR and aMDRD eGFR values were compared using the paired t test, Pearson correlation test, and the Bland-Altman plot. RESULTS: The mean age of patients was 53.21+/-14.45 years; of the 615 patients, 346 were male. The serum cystatin C-to-creatinine ratio was inversely correlated with the CKD stage. Compared with the K-aMDRD values, the results of the Hoek, Filler, and Le Bricon's cystatin C-based eGFR equations were lower in CKD Stages 1-3 and higher in Stages 4 and 5. However, the results of the Orebro-cystatin (Gentian) equation [GFR=100/ScytC (mL/minute/1.73m2) - 14] were similar to those of the K-aMDRD equation in CKD Stages 4 and 5 (15.44+/-9.45 vs. 15.17+/-9.05mL/minute/1.73m2, respectively; P=0.722; bias=0.27+/-8.87). CONCLUSION: The eGFRs obtained from the six cystatin C-based equations differed widely. Therefore, further studies are required to determine the most accurate equation to estimate GFR in Koreans with CKD.