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Improved estimation of glomerular filtration rate (GFR) by comparison of eGFR(cystatin C) and eGFR(creatinine)

Grubb, Anders LU ; Nyman, Ulf LU and Björk, Jonas LU (2012) In Scandinavian Journal of Clinical & Laboratory Investigation 72(1). p.73-77
Abstract
Objective. GFR-prediction equations based upon cystatin C and creatinine have better diagnostic performance in estimating GFR than equations based upon only one of the two markers. The present work concerns in what way a comparison between separate estimations of GFR based upon cystatin C (eGFR(cystatin C)) or creatinine (eGFR(creatinine)) can be used to evaluate the diagnostic performance of a combined cystatin C-and creatinine-based estimation of GFR. Methods. The difference between eGFR(cystatin C) and eGFR(creatinine) was compared with measured GFR (iohexol clearance) and a combined cystatin C- and creatinine-based estimation of GFR in a Swedish-Caucasian cohort of 857 adult patients. Results. A difference between eGFR(cystatin C) and... (More)
Objective. GFR-prediction equations based upon cystatin C and creatinine have better diagnostic performance in estimating GFR than equations based upon only one of the two markers. The present work concerns in what way a comparison between separate estimations of GFR based upon cystatin C (eGFR(cystatin C)) or creatinine (eGFR(creatinine)) can be used to evaluate the diagnostic performance of a combined cystatin C-and creatinine-based estimation of GFR. Methods. The difference between eGFR(cystatin C) and eGFR(creatinine) was compared with measured GFR (iohexol clearance) and a combined cystatin C- and creatinine-based estimation of GFR in a Swedish-Caucasian cohort of 857 adult patients. Results. A difference between eGFR(cystatin C) and eGFR(creatinine) of >= 40% indicated a markedly reduced diagnostic performance of the combined cystatin C- and creatinine-based estimation of GFR. Conclusion. Comparison of the agreement between eGFR(cystatin C) and eGFR(creatinine) can be used to evaluate the diagnostic performance of combined cystatin C-and creatinine-based estimations of GFR. If 'threshold values' for discordance are exceeded, it must be considered whether the clinical context requires the use of an invasive gold standard method to measure GFR. In some clinical contexts either creatinine or cystatin C are known to be invalidated as markers of GFR and in these situations the use of only the cystatin C-or the creatinine-based GFR estimate should be considered when the 'threshold values' are exceeded. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Kidney function, immunoassays, kidney diseases, cystatin C, creatinine
in
Scandinavian Journal of Clinical & Laboratory Investigation
volume
72
issue
1
pages
73 - 77
publisher
Informa Healthcare
external identifiers
  • wos:000299283700011
  • scopus:84856065361
ISSN
1502-7686
DOI
10.3109/00365513.2011.634023
language
English
LU publication?
yes
id
9a6c6688-178d-4704-999e-f1606d25c533 (old id 2355155)
date added to LUP
2012-03-01 11:26:49
date last changed
2017-09-24 03:53:21
@article{9a6c6688-178d-4704-999e-f1606d25c533,
  abstract     = {Objective. GFR-prediction equations based upon cystatin C and creatinine have better diagnostic performance in estimating GFR than equations based upon only one of the two markers. The present work concerns in what way a comparison between separate estimations of GFR based upon cystatin C (eGFR(cystatin C)) or creatinine (eGFR(creatinine)) can be used to evaluate the diagnostic performance of a combined cystatin C-and creatinine-based estimation of GFR. Methods. The difference between eGFR(cystatin C) and eGFR(creatinine) was compared with measured GFR (iohexol clearance) and a combined cystatin C- and creatinine-based estimation of GFR in a Swedish-Caucasian cohort of 857 adult patients. Results. A difference between eGFR(cystatin C) and eGFR(creatinine) of >= 40% indicated a markedly reduced diagnostic performance of the combined cystatin C- and creatinine-based estimation of GFR. Conclusion. Comparison of the agreement between eGFR(cystatin C) and eGFR(creatinine) can be used to evaluate the diagnostic performance of combined cystatin C-and creatinine-based estimations of GFR. If 'threshold values' for discordance are exceeded, it must be considered whether the clinical context requires the use of an invasive gold standard method to measure GFR. In some clinical contexts either creatinine or cystatin C are known to be invalidated as markers of GFR and in these situations the use of only the cystatin C-or the creatinine-based GFR estimate should be considered when the 'threshold values' are exceeded.},
  author       = {Grubb, Anders and Nyman, Ulf and Björk, Jonas},
  issn         = {1502-7686},
  keyword      = {Kidney function,immunoassays,kidney diseases,cystatin C,creatinine},
  language     = {eng},
  number       = {1},
  pages        = {73--77},
  publisher    = {Informa Healthcare},
  series       = {Scandinavian Journal of Clinical & Laboratory Investigation},
  title        = {Improved estimation of glomerular filtration rate (GFR) by comparison of eGFR(cystatin C) and eGFR(creatinine)},
  url          = {http://dx.doi.org/10.3109/00365513.2011.634023},
  volume       = {72},
  year         = {2012},
}