El desempeño de las ecuaciones de estimación del índice de filtrado glomerular basado en cistatina-C y creatinina depende de las características del paciente

Translated title of the contribution: Performance of cystatin C-and creatinine-based estimated glomerular filtration rate equations depends on patient characteristics

Jeffrey W. Meeusen, Andrew D Rule, Nikolay Voskoboev, Nikola A. Baumann, John C Lieske

Research output: Contribution to journalArticle

Abstract

Background: The Kidney Disease Improving Global Outcomes (KDIGO) guideline recommends use of a cystatin C-based estimated glomerular filtration rate (eGFR) to confirm creatinine-based eGFR between 45 and 59 mL · min-1 · (1.73 m2)-1. Prior studies have demonstrated that comorbidities such as solid-organ transplant strongly influence the relationship between measured GFR, creatinine, and cystatin C. Our objective was to evaluate the performance of cystatin C-based eGFR equations compared with creatinine-based eGFR and measured GFR across different clinical presentations. Methods: We compared the performance of the CKD-EPI 2009 creatinine-based estimated GFR equation (eGFRCr) and the newer CKD-EPI 2012 cystatin C-based equations (eGFRCys and eGFRCr-Cys) with measured GFR (iothalamate renal clearance) across defined patient populations. Patients (n = 1652) were categorized as transplant recipients (n = 568 kidney; n = 319 other organ), known chronic kidney disease (CKD) patients (n = 618), or potential kidney donors (n = 147). Results: eGFRCr-Cys showed the most consistent performance across different clinical populations. Among potential kidney donors without CKD [stage 2 or higher; eGFR >60 mL · min-1 · (1.73 m2)-1], eGFRCys and eGFRCr-Cys demonstrated significantly less bias than eGFRCr; however, all 3 equations substantially underestimated GFR when eGFR was <60 mL · min-1 · (1.73 m2)-1. Among transplant recipients with CKD stage 3B or greater [eGFR <45 mL · min-1 · (1.73 m2)-1], eGFRCys was significantly more biased than eGFRCr. No clear differences in eGFR bias between equations were observed among known CKD patients regardless of eGFR range or in any patient group with a GFR between 45 and 59 mL · min-1 · (1.73 m2)-1. Conclusions: The performance of eGFR equations depends on patient characteristics that are readily apparent on presentation. Among the 3 CKD-EPI equations, eGFRCr-Cys performed most consistently across the studied patient populations.

Original languageSpanish
Pages (from-to)107-116
Number of pages10
JournalActa Bioquimica Clinica Latinoamericana
Volume50
Issue number1
StatePublished - Mar 1 2016

Fingerprint

Cystatin C
Glomerular Filtration Rate
Creatinine
Chronic Renal Insufficiency
Transplants
Kidney
Iothalamic Acid
Tissue Donors
Population
Kidney Diseases
Comorbidity
Guidelines

ASJC Scopus subject areas

  • Clinical Biochemistry

Cite this

El desempeño de las ecuaciones de estimación del índice de filtrado glomerular basado en cistatina-C y creatinina depende de las características del paciente. / Meeusen, Jeffrey W.; Rule, Andrew D; Voskoboev, Nikolay; Baumann, Nikola A.; Lieske, John C.

In: Acta Bioquimica Clinica Latinoamericana, Vol. 50, No. 1, 01.03.2016, p. 107-116.

Research output: Contribution to journalArticle

@article{9b1593ff26594e5a99f5ceea0c64ec21,
title = "El desempe{\~n}o de las ecuaciones de estimaci{\'o}n del {\'i}ndice de filtrado glomerular basado en cistatina-C y creatinina depende de las caracter{\'i}sticas del paciente",
abstract = "Background: The Kidney Disease Improving Global Outcomes (KDIGO) guideline recommends use of a cystatin C-based estimated glomerular filtration rate (eGFR) to confirm creatinine-based eGFR between 45 and 59 mL · min-1 · (1.73 m2)-1. Prior studies have demonstrated that comorbidities such as solid-organ transplant strongly influence the relationship between measured GFR, creatinine, and cystatin C. Our objective was to evaluate the performance of cystatin C-based eGFR equations compared with creatinine-based eGFR and measured GFR across different clinical presentations. Methods: We compared the performance of the CKD-EPI 2009 creatinine-based estimated GFR equation (eGFRCr) and the newer CKD-EPI 2012 cystatin C-based equations (eGFRCys and eGFRCr-Cys) with measured GFR (iothalamate renal clearance) across defined patient populations. Patients (n = 1652) were categorized as transplant recipients (n = 568 kidney; n = 319 other organ), known chronic kidney disease (CKD) patients (n = 618), or potential kidney donors (n = 147). Results: eGFRCr-Cys showed the most consistent performance across different clinical populations. Among potential kidney donors without CKD [stage 2 or higher; eGFR >60 mL · min-1 · (1.73 m2)-1], eGFRCys and eGFRCr-Cys demonstrated significantly less bias than eGFRCr; however, all 3 equations substantially underestimated GFR when eGFR was <60 mL · min-1 · (1.73 m2)-1. Among transplant recipients with CKD stage 3B or greater [eGFR <45 mL · min-1 · (1.73 m2)-1], eGFRCys was significantly more biased than eGFRCr. No clear differences in eGFR bias between equations were observed among known CKD patients regardless of eGFR range or in any patient group with a GFR between 45 and 59 mL · min-1 · (1.73 m2)-1. Conclusions: The performance of eGFR equations depends on patient characteristics that are readily apparent on presentation. Among the 3 CKD-EPI equations, eGFRCr-Cys performed most consistently across the studied patient populations.",
author = "Meeusen, {Jeffrey W.} and Rule, {Andrew D} and Nikolay Voskoboev and Baumann, {Nikola A.} and Lieske, {John C}",
year = "2016",
month = "3",
day = "1",
language = "Spanish",
volume = "50",
pages = "107--116",
journal = "Acta Bioquimica Clinica Latinoamericana",
issn = "0325-2957",
publisher = "Federacion de Bioquimica",
number = "1",

}

TY - JOUR

T1 - El desempeño de las ecuaciones de estimación del índice de filtrado glomerular basado en cistatina-C y creatinina depende de las características del paciente

AU - Meeusen, Jeffrey W.

AU - Rule, Andrew D

AU - Voskoboev, Nikolay

AU - Baumann, Nikola A.

AU - Lieske, John C

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Background: The Kidney Disease Improving Global Outcomes (KDIGO) guideline recommends use of a cystatin C-based estimated glomerular filtration rate (eGFR) to confirm creatinine-based eGFR between 45 and 59 mL · min-1 · (1.73 m2)-1. Prior studies have demonstrated that comorbidities such as solid-organ transplant strongly influence the relationship between measured GFR, creatinine, and cystatin C. Our objective was to evaluate the performance of cystatin C-based eGFR equations compared with creatinine-based eGFR and measured GFR across different clinical presentations. Methods: We compared the performance of the CKD-EPI 2009 creatinine-based estimated GFR equation (eGFRCr) and the newer CKD-EPI 2012 cystatin C-based equations (eGFRCys and eGFRCr-Cys) with measured GFR (iothalamate renal clearance) across defined patient populations. Patients (n = 1652) were categorized as transplant recipients (n = 568 kidney; n = 319 other organ), known chronic kidney disease (CKD) patients (n = 618), or potential kidney donors (n = 147). Results: eGFRCr-Cys showed the most consistent performance across different clinical populations. Among potential kidney donors without CKD [stage 2 or higher; eGFR >60 mL · min-1 · (1.73 m2)-1], eGFRCys and eGFRCr-Cys demonstrated significantly less bias than eGFRCr; however, all 3 equations substantially underestimated GFR when eGFR was <60 mL · min-1 · (1.73 m2)-1. Among transplant recipients with CKD stage 3B or greater [eGFR <45 mL · min-1 · (1.73 m2)-1], eGFRCys was significantly more biased than eGFRCr. No clear differences in eGFR bias between equations were observed among known CKD patients regardless of eGFR range or in any patient group with a GFR between 45 and 59 mL · min-1 · (1.73 m2)-1. Conclusions: The performance of eGFR equations depends on patient characteristics that are readily apparent on presentation. Among the 3 CKD-EPI equations, eGFRCr-Cys performed most consistently across the studied patient populations.

AB - Background: The Kidney Disease Improving Global Outcomes (KDIGO) guideline recommends use of a cystatin C-based estimated glomerular filtration rate (eGFR) to confirm creatinine-based eGFR between 45 and 59 mL · min-1 · (1.73 m2)-1. Prior studies have demonstrated that comorbidities such as solid-organ transplant strongly influence the relationship between measured GFR, creatinine, and cystatin C. Our objective was to evaluate the performance of cystatin C-based eGFR equations compared with creatinine-based eGFR and measured GFR across different clinical presentations. Methods: We compared the performance of the CKD-EPI 2009 creatinine-based estimated GFR equation (eGFRCr) and the newer CKD-EPI 2012 cystatin C-based equations (eGFRCys and eGFRCr-Cys) with measured GFR (iothalamate renal clearance) across defined patient populations. Patients (n = 1652) were categorized as transplant recipients (n = 568 kidney; n = 319 other organ), known chronic kidney disease (CKD) patients (n = 618), or potential kidney donors (n = 147). Results: eGFRCr-Cys showed the most consistent performance across different clinical populations. Among potential kidney donors without CKD [stage 2 or higher; eGFR >60 mL · min-1 · (1.73 m2)-1], eGFRCys and eGFRCr-Cys demonstrated significantly less bias than eGFRCr; however, all 3 equations substantially underestimated GFR when eGFR was <60 mL · min-1 · (1.73 m2)-1. Among transplant recipients with CKD stage 3B or greater [eGFR <45 mL · min-1 · (1.73 m2)-1], eGFRCys was significantly more biased than eGFRCr. No clear differences in eGFR bias between equations were observed among known CKD patients regardless of eGFR range or in any patient group with a GFR between 45 and 59 mL · min-1 · (1.73 m2)-1. Conclusions: The performance of eGFR equations depends on patient characteristics that are readily apparent on presentation. Among the 3 CKD-EPI equations, eGFRCr-Cys performed most consistently across the studied patient populations.

UR - http://www.scopus.com/inward/record.url?scp=84975855919&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84975855919&partnerID=8YFLogxK

M3 - Article

VL - 50

SP - 107

EP - 116

JO - Acta Bioquimica Clinica Latinoamericana

JF - Acta Bioquimica Clinica Latinoamericana

SN - 0325-2957

IS - 1

ER -