A comparison of plasma cystatin C and plasma creatinine for the screening of renal function in lithium-treated patients.
(2010) In Clinical Nephrology 74(2). p.132-140- Abstract
- Background: Renal insufficiency is a serious complication of lithium treatment. Therefore, regular monitoring of plasma (P) creatinine is always part of lithium treatment safety routines. Recently P-cystatin C-estimated glomerular filtration rate (cystatin C-eGFR) had been launched as a preferable alternative to P-creatinine. Aims: To find out which of the two alternatives to prefer in the safety routines for lithium-treated patients. Material: All 201 patients on lithium treatment at the Department of Psychiatry in Lund, Sweden. Methods: During 14 months P-cystatin C was included in the safety routines besides routine P-creatinine every 4 months. At the end of the study period, 182 patients were eligible for analysis. With iohexol... (More)
- Background: Renal insufficiency is a serious complication of lithium treatment. Therefore, regular monitoring of plasma (P) creatinine is always part of lithium treatment safety routines. Recently P-cystatin C-estimated glomerular filtration rate (cystatin C-eGFR) had been launched as a preferable alternative to P-creatinine. Aims: To find out which of the two alternatives to prefer in the safety routines for lithium-treated patients. Material: All 201 patients on lithium treatment at the Department of Psychiatry in Lund, Sweden. Methods: During 14 months P-cystatin C was included in the safety routines besides routine P-creatinine every 4 months. At the end of the study period, 182 patients were eligible for analysis. With iohexol clearance as reference for GFR (performed in 111/182 patients) we calculated positive and negative predictive values (PPV, NPV) for P-creatinine and for creatinine-eGFR and cystatin C-eGFR, obtained by prediction equations. We also calculated the agreement between the measures of GFR (including repeatability). Results: PPV for cystatin C-eGFR (65%) was better than for creatinine-eGFR (48%). Combining the two resulted in a PPV of 56% and marginally increased NPV to 95%. The average of cystatin C-eGFR and creatinine-eGFR yielded PPV 67% and NPV 92%. The agreement between creatinine-eGFR and GFR was better than the agreement between cystatin C-eGFR and GFR, but both were clinically unacceptable. The repeatability of P-creatinine was acceptable for psychiatric purposes. The repeatability of cystatin C-eGFR was inferior to that of P-creatinine. Conclusion: Our results do not justify replacing P-creatinine by cystatin C-eGFR in the lithium treatment safety routines. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1644966
- author
- Olsson, C L ; Rippe, Bengt LU and Bendz, Hans LU
- organization
- publishing date
- 2010
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Clinical Nephrology
- volume
- 74
- issue
- 2
- pages
- 132 - 140
- publisher
- Dustri-Verlag
- external identifiers
-
- wos:000280754500007
- pmid:20630133
- scopus:77955723246
- ISSN
- 0301-0430
- language
- English
- LU publication?
- yes
- id
- 43d50b1a-4a97-48ae-af6a-12d75974e182 (old id 1644966)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/20630133?dopt=Abstract
- date added to LUP
- 2016-04-04 09:28:24
- date last changed
- 2022-01-29 18:00:14
@article{43d50b1a-4a97-48ae-af6a-12d75974e182,
abstract = {{Background: Renal insufficiency is a serious complication of lithium treatment. Therefore, regular monitoring of plasma (P) creatinine is always part of lithium treatment safety routines. Recently P-cystatin C-estimated glomerular filtration rate (cystatin C-eGFR) had been launched as a preferable alternative to P-creatinine. Aims: To find out which of the two alternatives to prefer in the safety routines for lithium-treated patients. Material: All 201 patients on lithium treatment at the Department of Psychiatry in Lund, Sweden. Methods: During 14 months P-cystatin C was included in the safety routines besides routine P-creatinine every 4 months. At the end of the study period, 182 patients were eligible for analysis. With iohexol clearance as reference for GFR (performed in 111/182 patients) we calculated positive and negative predictive values (PPV, NPV) for P-creatinine and for creatinine-eGFR and cystatin C-eGFR, obtained by prediction equations. We also calculated the agreement between the measures of GFR (including repeatability). Results: PPV for cystatin C-eGFR (65%) was better than for creatinine-eGFR (48%). Combining the two resulted in a PPV of 56% and marginally increased NPV to 95%. The average of cystatin C-eGFR and creatinine-eGFR yielded PPV 67% and NPV 92%. The agreement between creatinine-eGFR and GFR was better than the agreement between cystatin C-eGFR and GFR, but both were clinically unacceptable. The repeatability of P-creatinine was acceptable for psychiatric purposes. The repeatability of cystatin C-eGFR was inferior to that of P-creatinine. Conclusion: Our results do not justify replacing P-creatinine by cystatin C-eGFR in the lithium treatment safety routines.}},
author = {{Olsson, C L and Rippe, Bengt and Bendz, Hans}},
issn = {{0301-0430}},
language = {{eng}},
number = {{2}},
pages = {{132--140}},
publisher = {{Dustri-Verlag}},
series = {{Clinical Nephrology}},
title = {{A comparison of plasma cystatin C and plasma creatinine for the screening of renal function in lithium-treated patients.}},
url = {{http://www.ncbi.nlm.nih.gov/pubmed/20630133?dopt=Abstract}},
volume = {{74}},
year = {{2010}},
}