Glomerular filtration rate estimation using cystatin C alone or combined with creatinine as a confirmatory test

Détails

ID Serval
serval:BIB_306367D6B528
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Glomerular filtration rate estimation using cystatin C alone or combined with creatinine as a confirmatory test
Périodique
Nephrol Dial Transplant
Auteur(s)
Fan L., Inker L. A., Rossert J., Froissart M., Rossing P., Mauer M., Levey A. S.
ISSN
1460-2385 (Electronic)
ISSN-L
0931-0509
Statut éditorial
Publié
Date de publication
2014
Volume
29
Numéro
6
Pages
1195-203
Langue
anglais
Notes
Fan, Li
Inker, Lesley A
Rossert, Jerome
Froissart, Marc
Rossing, Peter
Mauer, Michael
Levey, Andrew S
eng
U01 DK053869/DK/NIDDK NIH HHS/
Comparative Study
Research Support, Non-U.S. Gov't
England
2014/01/23 06:00
Nephrol Dial Transplant. 2014 Jun;29(6):1195-203. doi: 10.1093/ndt/gft509. Epub 2014 Jan 20.
Résumé
BACKGROUND: Glomerular filtration rate (GFR) estimating equations using the combination of creatinine and cystatin C (eGFRcr-cys) are more accurate than equations using either alone (eGFRcr or eGFRcys). New guidelines suggest measuring cystatin C as a confirmatory test when eGFRcr may be inaccurate, but do not specify demographic or clinical conditions in which eGFRcys or eGFRcr-cys are more accurate than eGFRcr nor which estimate to use in such circumstances. METHODS: We compared the performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in 1119 subjects in the CKD-EPI cystatin C external validation dataset. Subgroups were defined by eGFRcr, age, sex, diabetes status and body mass index (BMI). The reference test was GFR measured using urinary or plasma clearance of exogenous filtration markers. Cystatin C and creatinine assays were traceable to primary reference materials. Accuracy was defined as the absolute difference in eGFR compared with mGFR. RESULTS: The mean mGFR was 70 +/- 41 (SD) mL/min/1.73 m(2). eGFRcys was more accurate than eGFRcr at lower BMI and less accurate at higher BMI, especially at higher levels of eGFRcr. There were small differences in accuracy in people according to the diabetes status. eGFRcr-cys was as accurate or more accurate than eGFRcr or eGFRcys in these and all other subgroups. CONCLUSIONS: eGFRcr-cys, but not eGFRcys, is more accurate than eGFRcr in most subgroups we studied, suggesting preferential use of eGFRcr-cys when serum cystatin C is measured as a confirmatory test to obtain more accurate eGFR. Further studies are necessary to evaluate diagnostic strategies for using eGFRcys and eGFRcr-cys.
Mots-clé
Adult, Aged, Biomarkers/blood, Body Mass Index, Creatinine/*blood, Cross-Sectional Studies, Cystatin C/*blood, Diabetes Mellitus/metabolism, Female, Glomerular Filtration Rate/*physiology, Humans, Kidney Function Tests/standards, Male, Middle Aged, Predictive Value of Tests, Renal Insufficiency, Chronic/blood/*physiopathology, Ckd-epi, cystatin C, diagnostic test accuracy, estimated GFR
Pubmed
Open Access
Oui
Création de la notice
03/03/2016 17:49
Dernière modification de la notice
21/08/2019 6:35
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