The diagnostic value of rescaled renal biomarkers serum creatinine and serum cystatin C and their relation with measured glomerular filtration rate

Hans Pottel, Laurence Dubourg, Elke Schaeffner, 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, Sebastjan Bevc, Pierre Delanaye, Natalie Ebert

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background Serum creatinine (Scr) is the major contributing variable in glomerular filtration rate (GFR) estimating equations. Serum cystatin C (ScysC) based GFR estimating (eGFR)-equations have also been developed. The present study investigates the relation between ‘rescaled’ levels of these renal biomarkers (with reference interval of [0.67–1.33]) and measured GFR (mGFR). Methods We evaluated the diagnostic ability to detect impaired kidney function of the rescaled renal biomarkers in 8584 subjects from 12 cohorts with measured GFR, standardized Scr and ScysC. We calculated sensitivity and specificity of the rescaled biomarkers to identify kidney disease, with reference to a fixed (60 mL/min/1.73 m2) as well as an age-dependent threshold for mGFR. Results The upper reference limit of 1.33 for rescaled renal biomarkers is closely related to the age-dependent threshold for defining kidney status by mGFR with sensitivity and specificity for the rescaled biomarkers close to 90% for all ages. If the fixed threshold of 60 mL/min/1.73 m2 for mGFR is used, then lower specificity in children and sensitivity in older adults are observed. Conclusions Impaired kidney function can be diagnosed by rescaled renal biomarkers instead of eGFR-equations using the fixed threshold of 1.33 for all ages, consistent with an age-dependent threshold of mGFR.

Original languageEnglish (US)
Pages (from-to)164-170
Number of pages7
JournalClinica Chimica Acta
Volume471
DOIs
StatePublished - Aug 2017

Keywords

  • Cystatin C
  • Measured GFR
  • Serum creatinine

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Biochemistry, medical

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