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GFR estimation base...
GFR estimation based on standardized creatinine and cystatin C : A European multicenter analysis in older adults
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- Björk, Jonas (author)
- Lund University,Lunds universitet,Avdelningen för arbets- och miljömedicin,Institutionen för laboratoriemedicin,Medicinska fakulteten,Division of Occupational and Environmental Medicine, Lund University,Department of Laboratory Medicine,Faculty of Medicine,Skåne University Hospital
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- Bäck, Sten Erik (author)
- Skåne University Hospital
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- Ebert, Natalie (author)
- Charité - University Medicine Berlin
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- Evans, Marie (author)
- Karolinska Institutet
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- Grubb, Anders (author)
- Skåne University Hospital
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- Hansson, Magnus (author)
- Karolinska Institutet
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- Jones, Ian (author)
- Örebro University
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- Lamb, Edmund J. (author)
- Great Ormond Street Hospital
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- Martus, Peter (author)
- University of Tübingen
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- Schaeffner, Elke (author)
- Charité - University Medicine Berlin
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- Sjöström, Per (author)
- Örebro University
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- Nyman, Ulf (author)
- Lund University,Lunds universitet,Diagnostisk radiologi, Malmö,Forskargrupper vid Lunds universitet,Radiology Diagnostics, Malmö,Lund University Research Groups
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(creator_code:org_t)
- 2017-10-06
- 2018
- English.
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In: Clinical Chemistry and Laboratory Medicine. - : Walter de Gruyter GmbH. - 1437-4331 .- 1434-6621. ; 56:3, s. 422-435
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Abstract
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- Although recommended by the Kidney Disease Improving Global Outcomes, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPICR) creatinine equation was not targeted to estimate glomerular filtration rate (eGFR) among older adults. The Berlin Initiative Study (BIS1CR) equation was specifically developed in older adults, and the Lund-Malmö revised (LMRCR) and the Full Age Spectrum (FASCR) equations have shown promising results in older adults. Our aim was to validate these four creatinine equations, including addition of cystatin C in a large multicenter cohort of Europeans ≥70 years. A total of 3226 individuals (2638 with cystatin C) underwent GFR measurement (mGFR; median, 44 mL/min/1.73 m2) using plasma iohexol clearance. Bias, precision (interquartile range [IQR]), accuracy (percent of estimates ±30% of mGFR, P30), eGFR accuracy diagrams and probability diagrams to classify mGFR<45 mL/min/1.73 m2 were compared. The overall results of BIS1CR/CKD-EPICR/FASCR/LMRCR were as follows: median bias, 1.7/3.6/0.6/-0.7 mL/min/1.73 m2; IQR, 11.6/12.3/11.1/10.5 mL/min/1.73 m2; and P30, 77.5%/76.4%/80.9%/83.5% (significantly higher for LMR, p<0.001). Substandard P30 (<75%) was noted for all equations at mGFR<30 mL/min/1.73 m2, and at body mass index values <20 and ≥35 kg/m2. LMRCR had the most stable performance across mGFR subgroups. Only LMRCR and FASCR had a relatively constant small bias across eGFR levels. Probability diagrams exhibited wide eGFR intervals for all equations where mGFR<45 could not be confidently ruled in or out. Adding cystatin C improved P30 accuracy to 85.7/86.8/85.7/88.7 for BIS2CR+CYS/CKD-EPICR+CYS/FASCR+CYS/MEANLMR+CAPA. LMRCR and FASCR seem to be attractive alternatives to CKD-EPICR in estimating GFR by creatinine-based equations in older Europeans. Addition of cystatin C leads to important improvement in estimation performance.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Klinisk laboratoriemedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Clinical Laboratory Medicine (hsv//eng)
Keyword
- chronic kidney disease
- creatinine
- cystatin C
- glomerular filtration rate
- kidney function tests
- renal failure
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Björk, Jonas
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Bäck, Sten Erik
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Ebert, Natalie
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Evans, Marie
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Grubb, Anders
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Hansson, Magnus
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show more...
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Jones, Ian
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Lamb, Edmund J.
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Martus, Peter
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Schaeffner, Elke
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Sjöström, Per
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Nyman, Ulf
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Clinical Laborat ...
- Articles in the publication
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Clinical Chemist ...
- By the university
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Lund University
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Karolinska Institutet