Does cystatin C improve the precision of Cockcroft and Gault's creatinine clearance estimation?

Détails

ID Serval
serval:BIB_68C1B908B55D
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Does cystatin C improve the precision of Cockcroft and Gault's creatinine clearance estimation?
Périodique
Journal of Nephrology
Auteur⸱e⸱s
Gabutti L., Ferrari N., Mombelli G., Marone C.
ISSN
1121-8428 (Print)
ISSN-L
1121-8428
Statut éditorial
Publié
Date de publication
2004
Volume
17
Numéro
5
Pages
673-678
Langue
anglais
Notes
Publication types: Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
BACKGROUND: Cystatin C is increasingly used to estimate renal function, but its large intraindividual variability limits its practical value. This study aimed at verifying whether the clinical practice of associating cystatin C determination with serum creatinine (Cr) improved the ability of the Cockcroft and Gault formula to estimate creatinine clearance (CrCl).
METHODS: It was an observational cross-sectional study of 134 in-patients with mildly impaired renal function. Using the Hoek et al formula (glomerular filtration rate (GFR)/1.73m2 = - 4.32 + 80.35/cystatin C mg/L), multivariate linear regressions (LREG) and artificial neural networks (ANN), we integrated cystatin C in the Cockcroft and Gault formula and analyzed the potential superiority of this procedure by comparing its performance with that of the two algorithms taken separately.
RESULTS: The inclusion of cystatin C in the Cockcroft and Gault formula using the data of an LREG (CrCl = 0.371 x (Hoek et al) + 0.589 x Cockcroft and Gault), a simple mean between the two algorithms or ANN ameliorated the CrCl estimation precision allowing an absolute error reduction of approximately 4, 4 and 6%, respectively (relative values 12, 12 and 17%).
CONCLUSIONS: Although the combination of the Hoek et al and Cockcroft and Gault formulae using both linear and non-linear mathematical methods allowed a statistically significant reduction in the estimation error generated by Cockcroft and Gault, considering the small impact on the estimation precision and the large intraindividual variation of both cystatin C and Cr, this procedure probably has no clinical relevance.
Mots-clé
Adult, Aged, Algorithms, Creatinine/blood, Creatinine/urine, Cross-Sectional Studies, Cystatin C, Cystatins/blood, Female, Glomerular Filtration Rate, Humans, Kidney Diseases/blood, Kidney Diseases/diagnosis, Linear Models, Male, Middle Aged, Neural Networks (Computer), Reproducibility of Results
Pubmed
Création de la notice
24/07/2013 9:20
Dernière modification de la notice
16/04/2020 5:26
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