Estimating glomerular filtration rate for the full age spectrum from serum creatinine and cystatin C

Hans Pottel, Pierre Delanaye, Elke Schaeffner, Laurence Dubourg, Bjørn Odvar Eriksen, Toralf Melsom, Edmund J. Lamb, Andrew D Rule, Stephen T Turner, Richard J. Glassock, Vandréa De Souza, Luciano Selistre, Karolien Goffin, Steven Pauwels, Christophe Mariat, Martin Flamant, Natalie Ebert

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Background. We recently published and validated the new serum creatinine (Scr)-based full-age-spectrum equation (FAScrea) for estimating the glomerular filtration rate (GFR) for healthy and kidney-diseased subjects of all ages. The equation was based on the concept of normalized Scr and shows equivalent to superior prediction performance to the currently recommended equations for children, adolescents, adults and older adults. Methods. Based on an evaluation of the serum cystatin C (ScysC) distribution, we defined normalization constants for ScysC (QcysC = 0.82 mg/L for ages <70 years and QcysC = 0.95 mg/L for ages ≥70 years). By replacing Scr/Qcrea in the FAScrea equation with ScysC/QcysC, or with the average of both normalized biomarkers, we obtained new ScysC-based (FAScysC) and combined Scr-/ScysC-based FAS equations (FAScombi). To validate the new FAScysC and FAScombi we collected data on measured GFR, Scr, ScysC, age, gender, height and weight from 11 different cohorts including n = 6132 unique white subjects (368 children, aged ≤18 years, 4295 adults and 1469 older adults, aged ≥70 years). Results. In children and adolescents, the new FAScysC equation showed significantly better performance [percentage of patients within 30% of mGFR (P30) = 86.1%] than the Caucasian Asian Paediatric Adult Cohort equation (P30 = 76.6%; P < 0.0001), or the ScysC-based Schwartz equation (P30 = 68.8%; P < 0.0001) and the FAScombi equation outperformed all equations with P30 = 92.1% (P < 0.0001). In adults, the FAScysC equation (P30 = 82.6%) performed equally as well as the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPIcysC) (P30 = 80.4%) and the FAScombi equation (P30 = 89.9%) was also equal to the combined CKD-EPI equation (P30 = 88.2%). In older adults, FAScysC was superior (P30 = 88.2%) to CKD-EPIcysC (P30 = 84.4%; P < 0.0001) and the FAScombi equation (P30 = 91.2%) showed significantly higher performance than the combined CKD-EPI equation (P30 = 85.6%) (P < 0.0001). Conclusion. The FAS equation is not only applicable to all ages, but also for all recommended renal biomarkers and their combinations.

Original languageEnglish (US)
Pages (from-to)497-507
Number of pages11
JournalNephrology Dialysis Transplantation
Volume32
Issue number3
DOIs
StatePublished - Mar 1 2017

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Cystatin C
Glomerular Filtration Rate
Creatinine
Serum
Biomarkers
Kidney Diseases
Chronic Renal Insufficiency
Epidemiology

Keywords

  • all ages
  • all renal biomarkers
  • combined FAS equation
  • cystatin C
  • serum creatinine

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Pottel, H., Delanaye, P., Schaeffner, E., Dubourg, L., Eriksen, B. O., Melsom, T., ... Ebert, N. (2017). Estimating glomerular filtration rate for the full age spectrum from serum creatinine and cystatin C. Nephrology Dialysis Transplantation, 32(3), 497-507. https://doi.org/10.1093/ndt/gfw425

Estimating glomerular filtration rate for the full age spectrum from serum creatinine and cystatin C. / Pottel, Hans; Delanaye, Pierre; Schaeffner, Elke; Dubourg, Laurence; Eriksen, Bjørn Odvar; Melsom, Toralf; Lamb, Edmund J.; Rule, Andrew D; Turner, Stephen T; Glassock, Richard J.; De Souza, Vandréa; Selistre, Luciano; Goffin, Karolien; Pauwels, Steven; Mariat, Christophe; Flamant, Martin; Ebert, Natalie.

In: Nephrology Dialysis Transplantation, Vol. 32, No. 3, 01.03.2017, p. 497-507.

Research output: Contribution to journalArticle

Pottel, H, Delanaye, P, Schaeffner, E, Dubourg, L, Eriksen, BO, Melsom, T, Lamb, EJ, Rule, AD, Turner, ST, Glassock, RJ, De Souza, V, Selistre, L, Goffin, K, Pauwels, S, Mariat, C, Flamant, M & Ebert, N 2017, 'Estimating glomerular filtration rate for the full age spectrum from serum creatinine and cystatin C', Nephrology Dialysis Transplantation, vol. 32, no. 3, pp. 497-507. https://doi.org/10.1093/ndt/gfw425
Pottel, Hans ; Delanaye, Pierre ; Schaeffner, Elke ; Dubourg, Laurence ; Eriksen, Bjørn Odvar ; Melsom, Toralf ; Lamb, Edmund J. ; Rule, Andrew D ; Turner, Stephen T ; Glassock, Richard J. ; De Souza, Vandréa ; Selistre, Luciano ; Goffin, Karolien ; Pauwels, Steven ; Mariat, Christophe ; Flamant, Martin ; Ebert, Natalie. / Estimating glomerular filtration rate for the full age spectrum from serum creatinine and cystatin C. In: Nephrology Dialysis Transplantation. 2017 ; Vol. 32, No. 3. pp. 497-507.
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abstract = "Background. We recently published and validated the new serum creatinine (Scr)-based full-age-spectrum equation (FAScrea) for estimating the glomerular filtration rate (GFR) for healthy and kidney-diseased subjects of all ages. The equation was based on the concept of normalized Scr and shows equivalent to superior prediction performance to the currently recommended equations for children, adolescents, adults and older adults. Methods. Based on an evaluation of the serum cystatin C (ScysC) distribution, we defined normalization constants for ScysC (QcysC = 0.82 mg/L for ages <70 years and QcysC = 0.95 mg/L for ages ≥70 years). By replacing Scr/Qcrea in the FAScrea equation with ScysC/QcysC, or with the average of both normalized biomarkers, we obtained new ScysC-based (FAScysC) and combined Scr-/ScysC-based FAS equations (FAScombi). To validate the new FAScysC and FAScombi we collected data on measured GFR, Scr, ScysC, age, gender, height and weight from 11 different cohorts including n = 6132 unique white subjects (368 children, aged ≤18 years, 4295 adults and 1469 older adults, aged ≥70 years). Results. In children and adolescents, the new FAScysC equation showed significantly better performance [percentage of patients within 30{\%} of mGFR (P30) = 86.1{\%}] than the Caucasian Asian Paediatric Adult Cohort equation (P30 = 76.6{\%}; P < 0.0001), or the ScysC-based Schwartz equation (P30 = 68.8{\%}; P < 0.0001) and the FAScombi equation outperformed all equations with P30 = 92.1{\%} (P < 0.0001). In adults, the FAScysC equation (P30 = 82.6{\%}) performed equally as well as the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPIcysC) (P30 = 80.4{\%}) and the FAScombi equation (P30 = 89.9{\%}) was also equal to the combined CKD-EPI equation (P30 = 88.2{\%}). In older adults, FAScysC was superior (P30 = 88.2{\%}) to CKD-EPIcysC (P30 = 84.4{\%}; P < 0.0001) and the FAScombi equation (P30 = 91.2{\%}) showed significantly higher performance than the combined CKD-EPI equation (P30 = 85.6{\%}) (P < 0.0001). Conclusion. The FAS equation is not only applicable to all ages, but also for all recommended renal biomarkers and their combinations.",
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author = "Hans Pottel and Pierre Delanaye and Elke Schaeffner and Laurence Dubourg and Eriksen, {Bj{\o}rn Odvar} and Toralf Melsom and Lamb, {Edmund J.} and Rule, {Andrew D} and Turner, {Stephen T} and Glassock, {Richard J.} and {De Souza}, Vandr{\'e}a and Luciano Selistre and Karolien Goffin and Steven Pauwels and Christophe Mariat and Martin Flamant and Natalie Ebert",
year = "2017",
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TY - JOUR

T1 - Estimating glomerular filtration rate for the full age spectrum from serum creatinine and cystatin C

AU - Pottel, Hans

AU - Delanaye, Pierre

AU - Schaeffner, Elke

AU - Dubourg, Laurence

AU - Eriksen, Bjørn Odvar

AU - Melsom, Toralf

AU - Lamb, Edmund J.

AU - Rule, Andrew D

AU - Turner, Stephen T

AU - Glassock, Richard J.

AU - De Souza, Vandréa

AU - Selistre, Luciano

AU - Goffin, Karolien

AU - Pauwels, Steven

AU - Mariat, Christophe

AU - Flamant, Martin

AU - Ebert, Natalie

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Background. We recently published and validated the new serum creatinine (Scr)-based full-age-spectrum equation (FAScrea) for estimating the glomerular filtration rate (GFR) for healthy and kidney-diseased subjects of all ages. The equation was based on the concept of normalized Scr and shows equivalent to superior prediction performance to the currently recommended equations for children, adolescents, adults and older adults. Methods. Based on an evaluation of the serum cystatin C (ScysC) distribution, we defined normalization constants for ScysC (QcysC = 0.82 mg/L for ages <70 years and QcysC = 0.95 mg/L for ages ≥70 years). By replacing Scr/Qcrea in the FAScrea equation with ScysC/QcysC, or with the average of both normalized biomarkers, we obtained new ScysC-based (FAScysC) and combined Scr-/ScysC-based FAS equations (FAScombi). To validate the new FAScysC and FAScombi we collected data on measured GFR, Scr, ScysC, age, gender, height and weight from 11 different cohorts including n = 6132 unique white subjects (368 children, aged ≤18 years, 4295 adults and 1469 older adults, aged ≥70 years). Results. In children and adolescents, the new FAScysC equation showed significantly better performance [percentage of patients within 30% of mGFR (P30) = 86.1%] than the Caucasian Asian Paediatric Adult Cohort equation (P30 = 76.6%; P < 0.0001), or the ScysC-based Schwartz equation (P30 = 68.8%; P < 0.0001) and the FAScombi equation outperformed all equations with P30 = 92.1% (P < 0.0001). In adults, the FAScysC equation (P30 = 82.6%) performed equally as well as the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPIcysC) (P30 = 80.4%) and the FAScombi equation (P30 = 89.9%) was also equal to the combined CKD-EPI equation (P30 = 88.2%). In older adults, FAScysC was superior (P30 = 88.2%) to CKD-EPIcysC (P30 = 84.4%; P < 0.0001) and the FAScombi equation (P30 = 91.2%) showed significantly higher performance than the combined CKD-EPI equation (P30 = 85.6%) (P < 0.0001). Conclusion. The FAS equation is not only applicable to all ages, but also for all recommended renal biomarkers and their combinations.

AB - Background. We recently published and validated the new serum creatinine (Scr)-based full-age-spectrum equation (FAScrea) for estimating the glomerular filtration rate (GFR) for healthy and kidney-diseased subjects of all ages. The equation was based on the concept of normalized Scr and shows equivalent to superior prediction performance to the currently recommended equations for children, adolescents, adults and older adults. Methods. Based on an evaluation of the serum cystatin C (ScysC) distribution, we defined normalization constants for ScysC (QcysC = 0.82 mg/L for ages <70 years and QcysC = 0.95 mg/L for ages ≥70 years). By replacing Scr/Qcrea in the FAScrea equation with ScysC/QcysC, or with the average of both normalized biomarkers, we obtained new ScysC-based (FAScysC) and combined Scr-/ScysC-based FAS equations (FAScombi). To validate the new FAScysC and FAScombi we collected data on measured GFR, Scr, ScysC, age, gender, height and weight from 11 different cohorts including n = 6132 unique white subjects (368 children, aged ≤18 years, 4295 adults and 1469 older adults, aged ≥70 years). Results. In children and adolescents, the new FAScysC equation showed significantly better performance [percentage of patients within 30% of mGFR (P30) = 86.1%] than the Caucasian Asian Paediatric Adult Cohort equation (P30 = 76.6%; P < 0.0001), or the ScysC-based Schwartz equation (P30 = 68.8%; P < 0.0001) and the FAScombi equation outperformed all equations with P30 = 92.1% (P < 0.0001). In adults, the FAScysC equation (P30 = 82.6%) performed equally as well as the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPIcysC) (P30 = 80.4%) and the FAScombi equation (P30 = 89.9%) was also equal to the combined CKD-EPI equation (P30 = 88.2%). In older adults, FAScysC was superior (P30 = 88.2%) to CKD-EPIcysC (P30 = 84.4%; P < 0.0001) and the FAScombi equation (P30 = 91.2%) showed significantly higher performance than the combined CKD-EPI equation (P30 = 85.6%) (P < 0.0001). Conclusion. The FAS equation is not only applicable to all ages, but also for all recommended renal biomarkers and their combinations.

KW - all ages

KW - all renal biomarkers

KW - combined FAS equation

KW - cystatin C

KW - serum creatinine

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