Comparison of glomerular filtration rate estimating equations derived from creatinine and cystatin C : Validation in the Age, Gene/Environment Susceptibility-Reykjavik elderly cohort
(2018) In Nephrology Dialysis Transplantation 33(8). p.1380-1388- Abstract
Background. Validation studies comparing glomerular filtration rate (GFR) equations based on standardized creatinine and cystatin C assays in the elderly are needed. The Icelandic Age, Gene/Environment Susceptibility-Kidney cohort was used to compare two pairs of recently developed GFR equations, the revised Lund-Malmö creatinine equation (LMRCr) and the arithmetic mean of the LMRCr and Caucasian, Asian, Paediatric and Adult cystatin C equations (MEANLMRþCAPA), as well as the Full Age Spectrum creatinine equation (FASCr) and its combination with cystatin C (FASCrþCys), with the corresponding pair of Chronic Kidney Disease Epidemiology Collaboration equations... (More)
Background. Validation studies comparing glomerular filtration rate (GFR) equations based on standardized creatinine and cystatin C assays in the elderly are needed. The Icelandic Age, Gene/Environment Susceptibility-Kidney cohort was used to compare two pairs of recently developed GFR equations, the revised Lund-Malmö creatinine equation (LMRCr) and the arithmetic mean of the LMRCr and Caucasian, Asian, Paediatric and Adult cystatin C equations (MEANLMRþCAPA), as well as the Full Age Spectrum creatinine equation (FASCr) and its combination with cystatin C (FASCrþCys), with the corresponding pair of Chronic Kidney Disease Epidemiology Collaboration equations (CKD-EPICr and CKD-EPICrþCys). Methods. A total of 805 individuals, 74-93 years of age, underwent measurement of GFR (mGFR) using plasma clearance of iohexol. Four metrics were used to compare the performance of the GFR equations: bias, precision, accuracy [including the percentage of participants with estimated GFR (eGFR) within 30% of mGFR (P30)] and the ability to detect mGFR <60 mL/min/1.73 m2. Results. All equations had a P30 >90%. LMRCr and FASCr yielded significantly higher precision and P30 than CKD-EPICr, while bias was significantly worse. LMRCr, FASCr and CKD-EPICr showed similar ability to detect mGFR <60 mL/min/1.73 m2 based on the area under the receiver operating characteristic curves. MEANLMRþCAPA, FASCrþCys and CKD-EPICrþCys all exhibited consistent improvements compared with the corresponding creatinine-based equations. Conclusion. None of the creatinine-based equations was clearly superior overall in this community-dwelling elderly cohort. The addition of cystatin C improved all of the creatinine-based equations.
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- author
- Björk, Jonas LU ; Grubb, Anders LU ; Gudnason, Vilmundur ; Indridason, Olafur S. ; Levey, Andrew S. ; Palsson, Runolfur and Nyman, Ulf LU
- organization
- publishing date
- 2018
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Chronic kidney disease, Elderly, Glomerular filtration rate, Kidney function tests, Renal failure
- in
- Nephrology Dialysis Transplantation
- volume
- 33
- issue
- 8
- pages
- 9 pages
- publisher
- Oxford University Press
- external identifiers
-
- pmid:29040701
- scopus:85055350958
- ISSN
- 0931-0509
- DOI
- 10.1093/ndt/gfx272
- language
- English
- LU publication?
- yes
- id
- 609da5e0-13fc-434e-837a-b9105a1dd5d7
- date added to LUP
- 2018-11-20 11:47:03
- date last changed
- 2024-07-09 00:09:46
@article{609da5e0-13fc-434e-837a-b9105a1dd5d7, abstract = {{<p>Background. Validation studies comparing glomerular filtration rate (GFR) equations based on standardized creatinine and cystatin C assays in the elderly are needed. The Icelandic Age, Gene/Environment Susceptibility-Kidney cohort was used to compare two pairs of recently developed GFR equations, the revised Lund-Malmö creatinine equation (LMR<sub>Cr</sub>) and the arithmetic mean of the LMR<sub>Cr</sub> and Caucasian, Asian, Paediatric and Adult cystatin C equations (MEAN<sub>LMR</sub>þ<sub>CAPA</sub>), as well as the Full Age Spectrum creatinine equation (FAS<sub>Cr</sub>) and its combination with cystatin C (FAS<sub>Cr</sub>þ<sub>Cys</sub>), with the corresponding pair of Chronic Kidney Disease Epidemiology Collaboration equations (CKD-EPI<sub>Cr</sub> and CKD-EPI<sub>Cr</sub>þ<sub>Cys</sub>). Methods. A total of 805 individuals, 74-93 years of age, underwent measurement of GFR (mGFR) using plasma clearance of iohexol. Four metrics were used to compare the performance of the GFR equations: bias, precision, accuracy [including the percentage of participants with estimated GFR (eGFR) within 30% of mGFR (P<sub>30</sub>)] and the ability to detect mGFR <60 mL/min/1.73 m<sup>2</sup>. Results. All equations had a P<sub>30</sub> >90%. LMR<sub>Cr</sub> and FAS<sub>Cr</sub> yielded significantly higher precision and P<sub>30</sub> than CKD-EPI<sub>Cr</sub>, while bias was significantly worse. LMR<sub>Cr</sub>, FAS<sub>Cr</sub> and CKD-EPI<sub>Cr</sub> showed similar ability to detect mGFR <60 mL/min/1.73 m<sup>2</sup> based on the area under the receiver operating characteristic curves. MEAN<sub>LMR</sub>þCAPA, FAS<sub>Cr</sub>þ<sub>Cys</sub> and CKD-EPI<sub>Cr</sub>þ<sub>Cys</sub> all exhibited consistent improvements compared with the corresponding creatinine-based equations. Conclusion. None of the creatinine-based equations was clearly superior overall in this community-dwelling elderly cohort. The addition of cystatin C improved all of the creatinine-based equations.</p>}}, author = {{Björk, Jonas and Grubb, Anders and Gudnason, Vilmundur and Indridason, Olafur S. and Levey, Andrew S. and Palsson, Runolfur and Nyman, Ulf}}, issn = {{0931-0509}}, keywords = {{Chronic kidney disease; Elderly; Glomerular filtration rate; Kidney function tests; Renal failure}}, language = {{eng}}, number = {{8}}, pages = {{1380--1388}}, publisher = {{Oxford University Press}}, series = {{Nephrology Dialysis Transplantation}}, title = {{Comparison of glomerular filtration rate estimating equations derived from creatinine and cystatin C : Validation in the Age, Gene/Environment Susceptibility-Reykjavik elderly cohort}}, url = {{http://dx.doi.org/10.1093/ndt/gfx272}}, doi = {{10.1093/ndt/gfx272}}, volume = {{33}}, year = {{2018}}, }