Predicting the glomerular filtration rate from serum creatinine, serum cystatin C and the Cockcroft and Gault formula with regard to drug dosage adjustment

2004 ◽  
Vol 42 (02) ◽  
pp. 93-97 ◽  
Author(s):  
O. Schück ◽  
V. Teplan ◽  
J. Sibová ◽  
M. Štollová
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Filtration Rate ◽  
Dosage Adjustment ◽  
Drug Dosage ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Gault Formula ◽  
Drug Dosage Adjustment ◽  
Cockcroft And Gault

scholarly journals Comparison of Chronic Kidney Disease Epidemiology Collaboration Equations with Other Accepted Equations for Estimation of Glomerular Filtration Rate in Indian Chronic Kidney Disease Patients

2017 ◽  
Vol 16 (2) ◽  
pp. 238-244
Author(s):  
Kumaresan Ramanathan ◽  
Giri Padmanabhan
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Filtration Rate ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Disease Epidemiology ◽  
Measured Gfr

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

scholarly journals Estimation of Glomerular Filtration Rate From Serum Cystatin C and Creatinine in Patients with Thyroid Dysfunction

2012 ◽  
Vol 31 (2) ◽  
pp. 88-93
Author(s):  
Velibor Čabarkapa ◽  
Romana Mijović ◽  
Zoran Stošić ◽  
Nikola Ćurić ◽  
Radmila Žeravica ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Thyroid Dysfunction ◽  
Newly Diagnosed ◽  
Serum Concentrations ◽  
Serum Cystatin C ◽  
Serum Cystatin

Estimation of Glomerular Filtration Rate From Serum Cystatin C and Creatinine in Patients with Thyroid DysfunctionGiven that thyroid function influences serum cystatin C and creatinine levels, the question arises as to whether it is possible to accurately estimate glomerular filtration rate (GFR) in patients with thyroid dysfunction. The objective of the study was to determine serum cystatin C and creatinine levels and estimate GFR in patients with thyroid dysfunction. The study included 32 cases with newly diagnosed hyperthyroidism and 27 cases with newly diagnosed hypothyroidism, as well as 20 healthy controls matched for sex and age with the cases. Serum concentrations of thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4), creatinine and cystatin C were measured in all study subjects. GFR was estimated using the Modification of Diet in Renal Disease (MDRD), the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and cystatin C-based equations. Serum cystatin C levels were significantly higher in hyperthyroid subjects compared to controls (1.32±0.31 vs. 0.89±0.15; p<0.01). Serum creatinine levels were significantly lower in hyperthyroid subjects compared to controls (60.6±10.2 vs. 76.4±8.6; p<0.01), and significantly higher in hypothyroid subjects compared to controls (94.5±13.2 vs. 76.4±8.6; p<0.01). GFR estimated with the MDRD equations was significantly higher in hyperthyroid subjects compared to hypothyroid subjects (101.6±20.7 vs. 64.1±11.6 mL/min/1.73m2; p<0.01). GFR estimated with the equation based on serum cystatin C was significantly lower in hyperthyroid subjects compared to hypothyroid subjects (59.2±22.1 vs. 92.1±16.0 mL/min/1.73m2; p<0.01). Although serum cystatin C is regarded a reliable marker of GFR and more sensitive than serum creatinine, it has limitations in patients with thyroid dysfunction, due to significant changes in its serum concentrations regardless of renal function. In patients with thyroid dysfunction GFR should therefore be estimated using the equations based on serum creatinine.

Cystatin C improves the detection of mild renal dysfunction in older patients

2003 ◽  
Vol 40 (6) ◽  
pp. 648-655 ◽  
Author(s):  
Shelagh E O'Riordan ◽  
Michelle C Webb ◽  
Helen J Stowe ◽  
David E Simpson ◽  
Madhu Kandarpa ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Older People ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Older Patients ◽  
Filtration Rate ◽  
Serum Cystatin C ◽  
Serum Cystatin

Background: Conventional estimates of glomerular dysfunction, including serum creatinine and creatinine clearance, are inadequate in older people. In this study we have compared the diagnostic accuracy of a novel test of kidney disease, cystatin C, against these markers in older patients with a range of renal function. Methods: Fifty-three patients (mean age 79.6 years, range 69-92 years) with a variety of medical diagnoses were recruited via outpatient clinics. Exclusion criteria included active rheumatoid disease, known current malignancy, renal replacement therapy/renal transplantation and cognitive impairment. 51Cr-EDTA was used as the reference method against which the other markers of glomerular filtration rate were compared using regression analyses. Results: The best fit with glomerular filtration rate was given by Cockcroft and Gault calculated clearance ( R2 = 0.83), followed by serum cystatin C ( R2 = 0.79), serum creatinine ( R2 = 0.76) and creatinine clearance ( R2 = 0.73). The accuracy for glomerular filtration rate prediction was poor for all markers. Serum cystatin C detected nearly all patients with mild renal impairment whereas serum creatinine only detected half of these cases. Regression modelling predicted that the upper limit of normal for serum cystatin C would be exceeded as glomerular filtration rate fell below 64 mL/min/1.73 m2, compared with 44 mL/min/1.73 m2 for serum creatinine. Conclusion: Serum cystatin C is a simple and sensitive screening test for kidney dysfunction in older people.

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