Advanced

Prevalence and determinants of differences in cystatin C and creatinine-based estimated glomerular filtration rate in community-dwelling older adults : A cross-sectional study

Legrand, Helen LU ; Werner, Karin LU ; Christensson, Anders LU ; Pihlsgård, Mats LU and Elmståhl, Sölve LU (2017) In BMC Nephrology 18(1).
Abstract

Background: Differences in cystatin C and creatinine-based estimated glomerular filtration rate (EGFR) can lead to clinical uncertainty. Existing EGFR equations perform poorly in a subset of individuals. This study aims to describe the prevalence of differences between cystatin C-based (EGFRcys) and creatinine-based (EGFRcreat) EGFR in older adults and to explore which subsets of individuals may be most affected by differing estimations. Methods: In this cross-sectional study, participants from a cohort of community-dwelling older adults were examined at a baseline visit in 2001-2004 as part of the larger "Good Aging in Skåne" study. Exposure variables were obtained from questionnaires, interviews, examinations,... (More)

Background: Differences in cystatin C and creatinine-based estimated glomerular filtration rate (EGFR) can lead to clinical uncertainty. Existing EGFR equations perform poorly in a subset of individuals. This study aims to describe the prevalence of differences between cystatin C-based (EGFRcys) and creatinine-based (EGFRcreat) EGFR in older adults and to explore which subsets of individuals may be most affected by differing estimations. Methods: In this cross-sectional study, participants from a cohort of community-dwelling older adults were examined at a baseline visit in 2001-2004 as part of the larger "Good Aging in Skåne" study. Exposure variables were obtained from questionnaires, interviews, examinations, and medical records. Blood samples were taken during the baseline visit, cryopreserved, and analyzed at a later time for biomarkers. The CKD-EPI equations were used to estimate GFR. Initial descriptive analyses were performed on 2931 individuals. A total of 2532 participants were included in the final multiple linear regression. Results: Nearly two-Thirds of participants had EGFR differences exceeding 10%, with nearly 20 % of participants having EGFR differences exceeding 30%. Smoking, age, body mass index (BMI), C-reactive protein (CRP), glucocorticoid use, and mean EGFR were correlated with differences between EGFRcreat and EGFRcys. Conclusions: Differences between EGFRcreat and EGFRcys are common and often of large magnitude in this community-dwelling population of older adults. The finding of multiple non-GFR determinants correlated to differences in GFR estimations can help direct future research to improve EGFR equations for subgroups prone to conflicting GFR estimations or to guide choice of biomarker for GFR estimation in these subgroups.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Community-dwelling, Creatinine, Cystatin C, Glomerular filtration rate, Older adults
in
BMC Nephrology
volume
18
issue
1
publisher
BioMed Central
external identifiers
  • scopus:85037620775
  • wos:000416930500002
ISSN
1471-2369
DOI
10.1186/s12882-017-0759-3
language
English
LU publication?
yes
id
9de09d43-0072-49c9-a9a7-ff7a88f39875
date added to LUP
2018-01-05 14:37:34
date last changed
2018-07-07 03:00:23
@article{9de09d43-0072-49c9-a9a7-ff7a88f39875,
  abstract     = {<p>Background: Differences in cystatin C and creatinine-based estimated glomerular filtration rate (EGFR) can lead to clinical uncertainty. Existing EGFR equations perform poorly in a subset of individuals. This study aims to describe the prevalence of differences between cystatin C-based (EGFR<sub>cys</sub>) and creatinine-based (EGFR<sub>creat</sub>) EGFR in older adults and to explore which subsets of individuals may be most affected by differing estimations. Methods: In this cross-sectional study, participants from a cohort of community-dwelling older adults were examined at a baseline visit in 2001-2004 as part of the larger "Good Aging in Skåne" study. Exposure variables were obtained from questionnaires, interviews, examinations, and medical records. Blood samples were taken during the baseline visit, cryopreserved, and analyzed at a later time for biomarkers. The CKD-EPI equations were used to estimate GFR. Initial descriptive analyses were performed on 2931 individuals. A total of 2532 participants were included in the final multiple linear regression. Results: Nearly two-Thirds of participants had EGFR differences exceeding 10%, with nearly 20 % of participants having EGFR differences exceeding 30%. Smoking, age, body mass index (BMI), C-reactive protein (CRP), glucocorticoid use, and mean EGFR were correlated with differences between EGFR<sub>creat</sub> and EGFR<sub>cys</sub>. Conclusions: Differences between EGFR<sub>creat</sub> and EGFR<sub>cys</sub> are common and often of large magnitude in this community-dwelling population of older adults. The finding of multiple non-GFR determinants correlated to differences in GFR estimations can help direct future research to improve EGFR equations for subgroups prone to conflicting GFR estimations or to guide choice of biomarker for GFR estimation in these subgroups.</p>},
  articleno    = {350},
  author       = {Legrand, Helen and Werner, Karin and Christensson, Anders and Pihlsgård, Mats and Elmståhl, Sölve},
  issn         = {1471-2369},
  keyword      = {Community-dwelling,Creatinine,Cystatin C,Glomerular filtration rate,Older adults},
  language     = {eng},
  month        = {12},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {BMC Nephrology},
  title        = {Prevalence and determinants of differences in cystatin C and creatinine-based estimated glomerular filtration rate in community-dwelling older adults : A cross-sectional study},
  url          = {http://dx.doi.org/10.1186/s12882-017-0759-3},
  volume       = {18},
  year         = {2017},
}