Cystatin C-based Glomerular Filtration Rate Estimating Equations in Early Chronic Kidney Disease.
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Date
2014-04
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Abstract
Objective: To Compare performance of combined creatinine and
cystatin C-based equation with equations based on either
cystatin C or creatinine alone, in early chronic kidney disease.
Design: Diagnostic accuracy study.
Setting: Tertiary-care hospital.
Patients: One hundred children with chronic kidney disease who
underwent 99mTc diethylenetriamine pentaacetic acid (DTPA)
glomerular filtration rate measurement.
Methods: Estimating equations for glomerular filtration rate
(GFR) based on serum cystatin C alone and in combination with
serum creatinine were generated using regression analyses.
These equations and the creatinine-based equation [0.42 x
height/creatinine] were validated in 42 children with glomerular
filteration rate between 60 and 90 mL/min/1.73 m2. Bias,
precision and accuracy of estimating equations using DTPA
glomerular filteration rate as gold standard.
Results: Cystatin C-based equation (GFR=96.9 - 30.4 x cystatin)
overestimated while the combined cystatin C-and creatininebased
equation [GFR=11.45 x (height/creatinine) 0.356 x (1/
cystatin) 0.188] underestimated the measured GFR. Cystatin Cbased
equation had less bias (1.9 vs. 12.4 ml/min/1.73 m2), and
higher precision (13.1 vs. 25.6 mL/min/1.73 m2) and accuracy
(92.1% vs. 75.7%) than creatinine-based equation. The
combined cystatin C and creatinine equation had bias (-1.4 mL/
min/1.73 m2) precision (15.2 mL/min/1.73 m2) and accuracy
(91.2%) similar to cystatin C-based equation.
Conclusions: Cystatin C-based equation has a better
performance in estimating glomerular filtration rate than
creatinine-based equation in children with early chronic kidney
disease. Addition of creatinine equation does not improve the
performance of the cystatin C-based equation.
Description
Keywords
Chronic renal insufficiency, Creatinine, Kidney function test, Tc-DTPA
Citation
Hari Pankaj, Ramakrishnan Lakshmy, Gupta Ruby, Kumar Rakesh, Bagga Arvind. Cystatin C-based Glomerular Filtration Rate Estimating Equations in Early Chronic Kidney Disease. Indian Pediatrics. 2014 Apr; 51(4): 273-277.