scholarly journals Comparison of CKD-EPI Cystatin C and Creatinine Glomerular Filtration Rate Estimation Equations in Asian Indians

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Boon Wee Teo ◽  
Charumathi Sabanayagam ◽  
Jiemin Liao ◽  
Qi Chun Toh ◽  
Sharon Saw ◽  
...  

Background. Chronic kidney disease (CKD) is identified in the general population using estimated glomerular filtration rates (eGFR) calculated from a serum creatinine-based equation, the chronic kidney disease-epidemiology collaboration (CKD-EPI) equation. Using serum cystatin C in combination may improve eGFR accuracy. We evaluated the new CKD-EPI equations incorporating cystatin C in a population of Asian Indians in classifying CKD across body mass index, diabetes, and hypertension status.Methods. We retrieved standardized serum creatinine and serum cystatin C data from a cohort of 2877 Asian Indians aged 40–80 years from the Singapore Indian Eye Study and calculated eGFR (in mL/min/1.73 m2) with the new CKD-EPI equations and serum creatinine only equation.Results. The creatinine only equation mean eGFR (88 ± 17) was similar to using spline Log cystatin C (88 ± 22). The lowest mean eGFR (81 ± 21) was obtained with the spline Log cystatin C—age, sex, and weight equation. The creatinine only equation had the fewest participants (7.1%) with eGFR <60 and spline Log cystatin C—age, sex, and weight equation had the most (16.1%).Conclusions. Using serum cystatin C resulted in widely varying eGFR which significantly affected the classification of chronic kidney disease.

2017 ◽  
Vol 16 (2) ◽  
pp. 238-244
Author(s):  
Kumaresan Ramanathan ◽  
Giri Padmanabhan

Background and Aim: In routine clinical practice, the estimation of glomerular filtration rate (GFR) based on serum creatinine has been followed. However, the reliability of creatinine in estimation of GFR is biased and imprecise, leading to the misdiagnosis of chronic kidney disease (CKD). The serum cystatin C is an alternative marker for estimating GFR. Hence, we aimed to compare the newly proposed Chronic Kidney Disease Epidemiology Collaboration Equations (CKD-EPI) with four approved equations based on both creatinine and cystatin C with reference to Tc-99m-diethylenetriamine pentaacetate (Tc-99m-DTPA) considered as a standard.Materials and Methods:Two hundred and one patients were enrolled in the study from a private nephrology outpatient clinic(OPD), Tiruchirappalli, India. The serum creatinine and cystatin C were measured along with routine biochemistry tests. The measurement of GFR was done by Tc-99m-DTPA gates method. The estimated GFR (eGFR) were calculated using serum cystatin C and creatinine based formulae along with the new CKD-EPI formulae. All eGFR estimations were compared with the measured GFR by gates method.Results: The average measured GFR of end stage, severe, moderate, mild renal disease and normal patient groups were 10.17±2.47, 22.58±4.40, 39.05±7.06, 69.62±24.64 and 118.06±29.23 respectively. When comparing the diagnostic accuracy for predicting GFR using well established formulae, the cystatin C based formulae have shown to be highly accurate in all stages of CKD than creatinine based formulae. Among cystatin C based formulae, CKD-EPI Cystatin C had relatively better diagnostic accuracy for predicting GFR in all stages of CKD.Conclusion: CKD-EPI Cystatin C formula has unbiased and more accurate to predict GFR in all stages of CKD.Bangladesh Journal of Medical Science Vol.16(2) 2017 p.238-244


2012 ◽  
Vol 58 (2) ◽  
pp. 450-457 ◽  
Author(s):  
Boon Wee Teo ◽  
Hui Xu ◽  
Danhua Wang ◽  
Jialiang Li ◽  
Arvind Kumar Sinha ◽  
...  

Abstract BACKGROUND The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is most accurate for estimating glomerular filtration rate (GFR) but requires an adjustment for African-American patients. Estimation equations are also improved with the use of serum cystatin C combined with standardized creatinine. Combination equations have been derived by the CKD-EPI and Chinese investigators. We investigated whether these cystatin C–based equations improve estimation adequately, so that adjustments for ethnicity are not required in a multiethnic Asian population with chronic kidney disease (CKD). METHODS This was a cross-sectional study of 232 stable CKD patients who underwent GFR measurements using 3-sample plasma clearances of 99mTc-DTPA, and for whom serum cystatin C and creatinine were quantified. RESULTS For all patients, the median biases with cystatin C equations were generally greater than with the CKD-EPI equation, and precision and root mean square error (RMSE) were not significantly better. However, the combination serum creatinine and cystatin C equation improved the precision, RMSE, and percentage of estimated GFR to within 15% and 30% of the measured GFR (57.3% vs 50.0%, 88.4% vs 82.8%, respectively). The derived ethnicity coefficients for the combination equation were all &gt;1 (1.009–1.082) but small, suggesting that coefficients are not required. The Chinese-specific equations were more biased and performed more poorly than the CKD-EPI equation. CONCLUSIONS The use of a cystatin C and creatinine combination equation for estimating GFR in a multiethnic Asian population with CKD does not require ethnicity coefficients because the derived coefficients are very close to each other.


2011 ◽  
Vol 58 (4) ◽  
pp. 682-684 ◽  
Author(s):  
Lesley A. Inker ◽  
John Eckfeldt ◽  
Andrew S. Levey ◽  
Catherine Leiendecker-Foster ◽  
Gregory Rynders ◽  
...  

2010 ◽  
Vol 114 (2) ◽  
pp. c118-c126 ◽  
Author(s):  
Radovan Hojs ◽  
Sebastjan Bevc ◽  
Robert Ekart ◽  
Maksimiljan Gorenjak ◽  
Ludvik Puklavec

2015 ◽  
Vol 38 (1) ◽  
pp. 1
Author(s):  
Aisyah Elliyanti ◽  
Iskandar Iskandar ◽  
Syaiful Azmi

AbstrakRenogram 99mTc-DTPA (diethylenetriamine pentacetic acid) memiliki beberapa kelebihan dalam mengukur laju filtrasi glomerulus (LFG). Cystatin-c digunakan sebagai petanda biologik baru untuk memperkirakan LFG. Tujuan penelitian ini adalah untuk menentukan korelasi nilai LFG antara renogram dengan cystatin-c dan kliren kreatinin pada pasien dengan penyakit ginjal kronis (PGK). Subjek penelitian adalah pasien PGK stadium dua berdasarkan hasil estimasi LFG dengan rumus Cockroft-Gault. Pasien yang memenuhi kriteria diperiksa renogram, kadar kreatinin serum, cystatin-c dan klirens kreatinin.Rerata LFG dari 30 orang subjek yang diperiksa dengan renogram, cystatin-c, creatinine clearance, Cockroft-Gault’s formula berturut turut adalah 64.96 ml/min/1.73m2 (SD 28.047), 53.37 ml/min/1.73m2 (SD 21.29), 58.09 ml/min/1.73m2 (SD 35.45), 46.00 ml/min/1.73m2 (SD 12.06). Korelasi antara renogram dengan cystatin-c dengan nilai r = 0.585 dan p = 0.0007, antara renogram dengan klirens kreatinin dengan nilai r = 0.388 dan p = 0.03) dan antara renogram dengan rumus Cockroft-Gault’s dengan nilai r = -0.029 dan p=0.87. Pada penelitian ini didapatkan hasil korelasi yang lebih baik antara renogram dengan cystatin-c dari pada antara renogram dengan klirens kreatinin dan antara renogram dengan rumus Cockroft-Gault’s. Lebih lanjut, cystain-c merupakan alternatif yang lebih baik untuk memperkirakan LFG jika metode pemeriksaan LFG yang mendekati teknik pemeriksaan yang ideal tidak tersedia.AbstractRenogram using 99mTc-DTPA (diethylenetriamine pentacetic acid) has advantages in the measurement of glomerular filtration rate (GFR). Serum cystatin-c was recently projected to be the new marker of estimated GFR. The aim of this study is to establish correlation between GFRs, derived from renogram with cystatin-c levels and creatinine clearances in chronic kidney disease patients.We put to study thirty consecutive stage two of chronic kidney disease patients assigned based on GFR estimation by Cockroft-Gault’s formula, taking into account the serum creatinine. Cystatin-c and creatinine clearance were performed to determine of GFR and renogram was included in this study. A total of thirty subjects, the mean of GFRs were taken from renogram, cystatin-c, creatinine clearance, Cockroft-Gault’s formula were 64.96 ml/min/1.73m2 (SD 28.047), 53.37 ml/min/1.73m2 (SD 21.29), 58.09 ml/min/1.73m2 (SD 35.45), 46.00 ml/min/1.73m2 (SD 12.06) respectively. A correlation between renogram with cystatin-c (r = 0.585 and p = 0.0007) and renogram with creatinine clearance (r = 0.388 and p = 0.03) and renogram with Cockroft-Gault’s formula (r = -0.029 and p=0.87). This study has shown that a better correlation between renogram with cystatin-c than with creatinine clearance or Cockroft-Gault’s formula. Furthermore, cystain-c would be better alternative method incase having problems to obtain a closest ideal methods for GFR.


2018 ◽  
Vol 4 (1) ◽  
pp. 3-12
Author(s):  
Md Anwarul Haque Faraji ◽  
Mohammed Rashed Anwar ◽  
Dilip Kumar Debnath ◽  
Md Babrul Alam ◽  
Syed Mahbub Morshed ◽  
...  

Background: Cystatin C is being considered as a potential replacement for serum creatinine as a filtration marker.Objectives: This present study was conducted to determine the validity of Cystatin C as a renal function test and to compare the Cystatin C and serum creatinine level between the CKD cases and person not having CKD.Methodology: The present case control study was conducted in the department of Nephrology of Dhaka Medical College Hospital during the period of January 2009 to December 2009 with the aim to find out the serum Cystatin C as diagnostic markers of chronic kidney disease. In the present study total 100 respondents were included. Among them 50 were CKD patients and another 50 were without CKD. Results: It was an age and sex matched study. Out of 50 patients with CKD, 29 (58.0%) were in the stage IV followed by 15 (30.0%) were in the stage III and rest 6 (12.0%) were in the stage V. In CKD group 31 (62.0%) had glomerulonephritis, 18 (36.0%) had HTN, 11 (22.0%) had DM and 3 (6.0%) had obstructive uropathy.  In without CKD group 9 (18.0%) had HTN, 6 (12.0%) had DM. Mean±SD of Serum Creatinine in CKD and without CKD groups were 5.73±2.69 and 0.85±0.11mg/dl respectively. Mean±SD of Serum Cystatin C in CKD and without CKD groups were 3.59±1.21 and 0.71±0.09 mg/dl respectively. In all patients sensitivity of Cystatin C to diagnose CKD was 100.0% and specificity also100.0%. Sensitivity of serum creatinine to diagnose CKD was 88.0% and specificity was 100.0%.Conclusions: Cystatin C proved more reliable than creatinine and was comparable to plasma creatinine and Cockcroft-Gault estimation. Serum Cystatin C had higher diagnostic accuracy with high sensitivity and specificity to detect renal function and is a reliable marker of renal function. Journal of Current and Advance Medical Research 2017;4(1):3-12


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Sebastjan Bevc ◽  
Radovan Hojs ◽  
Robert Ekart ◽  
Matej Završnik ◽  
Maksimiljan Gorenjak ◽  
...  

In clinical practice the glomerular filtration rate (GFR) is estimated from serum creatinine-based equations like the Cockcroft-Gault formula (C&G) and Modification of Diet in Renal Disease formula (MDRD). Recently, serum cystatin C-based equations, the newer creatinine formula (The Chronic Kidney Disease Epidemiology Collaboration formula (CKD-EPI)), and equation that use both serum creatinine and cystatin C (CKD-EPI creatinine & cystatin formula) were proposed as new GFR markers. Present study compares serum creatinine-based equations, combined (including both serum creatinine and cystatin C) equation, and serum simple cystatin C formula (100/serum cystatin C) against 51CrEDTA clearance in 113 adult overweight Caucasians with diabetes mellitus type 2 (DM2) and chronic kidney disease (CKD). The results of present study demonstrated that the simple cystatin C formula could be a useful tool for the evaluation of renal function in overweight patients with DM2 and impaired kidney function in daily clinical practice in hospital and especially in outpatients. Despite the advantages of the simple cystatin C formula, cystatin C-based equations cannot completely replace the “gold standard” for estimation of the GFR in a population of DM2 patients with CKD, but may contribute to a more accurate selection of patients requiring such invasive and costly procedures.


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