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New standardized cystatin C and creatinine GFR equations in children validated with inulin clearance

Berg, Ulla B.; Nyman, Ulf LU ; Back, Rune; Hansson, Magnus; Monemi, Kajsa Asling; Herthelius, Maria and Björk, Jonas LU (2015) In Pediatric Nephrology 30(8). p.1317-1326
Abstract
This study compares glomerular filtration rate (GFR) equations in children based on standardized cystatin C (CYSC) and creatinine (CREA) and their combinations with renal clearance of inulin (C-inulin). A total of 220 children with different renal disorders were referred for C-inulin (median 84 ml/min/1.73 m(2)). Bias, precision (interquartile range, IQR), and accuracy (percentage of estimates +/- 30 % of C-inulin; P30) were evaluated for two cystatin C equations, CAPA(CYSC) and Berg(CYSC), for creatinine equations, Schwartz(CREA) and Gao(CREA), the arithmetic mean of CAPA(CYSC) and Schwartz(CREA) (MEAN(CAPA+Schwartz)), Berg(CYSC) and Schwartz(CREA) (MEAN(BERG+SCHWARTZ)) and the composite equation Chehade(CYSC+CREA). Overall results of... (More)
This study compares glomerular filtration rate (GFR) equations in children based on standardized cystatin C (CYSC) and creatinine (CREA) and their combinations with renal clearance of inulin (C-inulin). A total of 220 children with different renal disorders were referred for C-inulin (median 84 ml/min/1.73 m(2)). Bias, precision (interquartile range, IQR), and accuracy (percentage of estimates +/- 30 % of C-inulin; P30) were evaluated for two cystatin C equations, CAPA(CYSC) and Berg(CYSC), for creatinine equations, Schwartz(CREA) and Gao(CREA), the arithmetic mean of CAPA(CYSC) and Schwartz(CREA) (MEAN(CAPA+Schwartz)), Berg(CYSC) and Schwartz(CREA) (MEAN(BERG+SCHWARTZ)) and the composite equation Chehade(CYSC+CREA). Overall results of CAPA(CYSC), Berg(CYSC), Schwartz(CREA), Gao(CREA), MEAN(CAPA+Schwartz,) MEAN(BERG+SCHWARTZ) and Chehade(CYSC+CREA) were: median bias -7.6/-4.9/-3.7/-2.3/-4.6/-4.0/-10.1 %, IQR 20.0/19.9/21.7/22.4/21.0/20.9/23.3 ml/min/1.73 m(2) and P30 86/86/80/83/89/91/83 %. The cystatin C equations, MEAN(CAPA+Schwartz) and MEAN(BERG+SCHWARTZ) had a more stable performance across subgroups compared with Schwartz(CREA), Gao(CREA) and Chehade(CYSC+CREA). Cystatin C was the preferred filtration marker for GFR estimation in children, while the benefit of combining cystatin C and creatinine deserves further investigations. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Creatinine, Cystatin C, of inulin, Clearance, Renal dysfunction, Renal function, Glomerular filtration rate
in
Pediatric Nephrology
volume
30
issue
8
pages
1317 - 1326
publisher
Springer
external identifiers
  • wos:000356959400014
  • scopus:84933180658
ISSN
1432-198X
DOI
10.1007/s00467-015-3060-3
language
English
LU publication?
yes
id
e3f85967-d2c7-447a-a391-4f20e6d68a83 (old id 7584813)
date added to LUP
2015-08-03 10:08:49
date last changed
2017-08-13 03:50:09
@article{e3f85967-d2c7-447a-a391-4f20e6d68a83,
  abstract     = {This study compares glomerular filtration rate (GFR) equations in children based on standardized cystatin C (CYSC) and creatinine (CREA) and their combinations with renal clearance of inulin (C-inulin). A total of 220 children with different renal disorders were referred for C-inulin (median 84 ml/min/1.73 m(2)). Bias, precision (interquartile range, IQR), and accuracy (percentage of estimates +/- 30 % of C-inulin; P30) were evaluated for two cystatin C equations, CAPA(CYSC) and Berg(CYSC), for creatinine equations, Schwartz(CREA) and Gao(CREA), the arithmetic mean of CAPA(CYSC) and Schwartz(CREA) (MEAN(CAPA+Schwartz)), Berg(CYSC) and Schwartz(CREA) (MEAN(BERG+SCHWARTZ)) and the composite equation Chehade(CYSC+CREA). Overall results of CAPA(CYSC), Berg(CYSC), Schwartz(CREA), Gao(CREA), MEAN(CAPA+Schwartz,) MEAN(BERG+SCHWARTZ) and Chehade(CYSC+CREA) were: median bias -7.6/-4.9/-3.7/-2.3/-4.6/-4.0/-10.1 %, IQR 20.0/19.9/21.7/22.4/21.0/20.9/23.3 ml/min/1.73 m(2) and P30 86/86/80/83/89/91/83 %. The cystatin C equations, MEAN(CAPA+Schwartz) and MEAN(BERG+SCHWARTZ) had a more stable performance across subgroups compared with Schwartz(CREA), Gao(CREA) and Chehade(CYSC+CREA). Cystatin C was the preferred filtration marker for GFR estimation in children, while the benefit of combining cystatin C and creatinine deserves further investigations.},
  author       = {Berg, Ulla B. and Nyman, Ulf and Back, Rune and Hansson, Magnus and Monemi, Kajsa Asling and Herthelius, Maria and Björk, Jonas},
  issn         = {1432-198X},
  keyword      = {Creatinine,Cystatin C,of inulin,Clearance,Renal dysfunction,Renal function,Glomerular filtration rate},
  language     = {eng},
  number       = {8},
  pages        = {1317--1326},
  publisher    = {Springer},
  series       = {Pediatric Nephrology},
  title        = {New standardized cystatin C and creatinine GFR equations in children validated with inulin clearance},
  url          = {http://dx.doi.org/10.1007/s00467-015-3060-3},
  volume       = {30},
  year         = {2015},
}