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Simple Cystatin C-Based Prediction Equations for Glomerular Filtration Rate Compared with the Modification of Diet in Renal Disease Prediction Equation for Adults and the Schwartz and the Counahan-Barratt Prediction Equations for Children.

Grubb, Anders LU ; Nyman, Ulf LU ; Björk, Jonas; Lindström, Veronica LU ; Rippe, Bengt LU ; Sterner, Gunnar LU and Christensson, Anders LU (2005) In Clinical Chemistry 51(8). p.1420-1431
Abstract

BACKGROUND: Serum creatinine is the most commonly used marker for estimation of glomerular filtration rate (GFR). To compensate for its drawbacks as a GFR marker, several prediction equations including several parameters are being used, with the Modification of Diet in Renal Disease (MDRD), Schwartz, and Counahan-Barratt equations being the ones most widely accepted for estimation of relative GFR in mL x min(-1) x (1.73 m(2))(-1). The present study analyzes whether these GFR prediction equations for adults and children might be replaced by simple prediction equations based on plasma concentrations of cystatin C.

METHODS: Data from 536 patients (0.3-93 years), consecutively referred for determination of GFR by an invasive gold... (More)

BACKGROUND: Serum creatinine is the most commonly used marker for estimation of glomerular filtration rate (GFR). To compensate for its drawbacks as a GFR marker, several prediction equations including several parameters are being used, with the Modification of Diet in Renal Disease (MDRD), Schwartz, and Counahan-Barratt equations being the ones most widely accepted for estimation of relative GFR in mL x min(-1) x (1.73 m(2))(-1). The present study analyzes whether these GFR prediction equations for adults and children might be replaced by simple prediction equations based on plasma concentrations of cystatin C.

METHODS: Data from 536 patients (0.3-93 years), consecutively referred for determination of GFR by an invasive gold standard procedure, were used for the analysis. Calculations of bias (median percentage of error), correlation (adjusted R(2)), and percentage of estimates within 30% and 50% of measured GFR were used in the comparisons.

RESULTS: A cystatin C-based prediction equation using only concentration in mg/L and a prepubertal factor: GFR [mL x min(-1) x (1.73 m(2))(-1)] = 84.69 x cystatin C (mg/L)(-1.680) x 1.384 (if a child <14 years) assessed GFR equally well or better than the simplified MDRD, the Schwartz, and the Counahan-Barratt prediction equations for the adult (> or =18 years) and juvenile groups of the investigated cohort. Age did not influence the cystatin C-based prediction equation for adults, whereas gender did, but with a factor close to unity (0.948 for females).

CONCLUSION: A GFR prediction equation based solely on cystatin C (in mg/L) and a prepubertal factor might replace the simplified MDRD prediction equation for adults and the Schwartz and Counahan-Barratt prediction equations for children.

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keywords
Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Algorithms, Biomarkers/blood, Child, Child, Preschool, Cystatin C, Cystatins/blood, Female, Glomerular Filtration Rate, Humans, Infant, Infant, Newborn, Kidney/physiopathology, Kidney Diseases/diagnosis, Male, Mathematics, Middle Aged, Predictive Value of Tests, Sex Factors
in
Clinical Chemistry
volume
51
issue
8
pages
1420 - 1431
publisher
American Association for Clinical Chemistry
external identifiers
  • pmid:15961546
  • wos:000230766000015
  • scopus:23044485568
ISSN
0009-9147
DOI
10.1373/clinchem.2005.051557
language
English
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yes
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dde08bdb-dd5a-4723-8f8f-37a691104598 (old id 139980)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15961546&dopt=Abstract
date added to LUP
2007-07-05 09:08:47
date last changed
2019-08-18 03:35:53
@article{dde08bdb-dd5a-4723-8f8f-37a691104598,
  abstract     = {<p>BACKGROUND: Serum creatinine is the most commonly used marker for estimation of glomerular filtration rate (GFR). To compensate for its drawbacks as a GFR marker, several prediction equations including several parameters are being used, with the Modification of Diet in Renal Disease (MDRD), Schwartz, and Counahan-Barratt equations being the ones most widely accepted for estimation of relative GFR in mL x min(-1) x (1.73 m(2))(-1). The present study analyzes whether these GFR prediction equations for adults and children might be replaced by simple prediction equations based on plasma concentrations of cystatin C.</p><p>METHODS: Data from 536 patients (0.3-93 years), consecutively referred for determination of GFR by an invasive gold standard procedure, were used for the analysis. Calculations of bias (median percentage of error), correlation (adjusted R(2)), and percentage of estimates within 30% and 50% of measured GFR were used in the comparisons.</p><p>RESULTS: A cystatin C-based prediction equation using only concentration in mg/L and a prepubertal factor: GFR [mL x min(-1) x (1.73 m(2))(-1)] = 84.69 x cystatin C (mg/L)(-1.680) x 1.384 (if a child &lt;14 years) assessed GFR equally well or better than the simplified MDRD, the Schwartz, and the Counahan-Barratt prediction equations for the adult (&gt; or =18 years) and juvenile groups of the investigated cohort. Age did not influence the cystatin C-based prediction equation for adults, whereas gender did, but with a factor close to unity (0.948 for females).</p><p>CONCLUSION: A GFR prediction equation based solely on cystatin C (in mg/L) and a prepubertal factor might replace the simplified MDRD prediction equation for adults and the Schwartz and Counahan-Barratt prediction equations for children.</p>},
  author       = {Grubb, Anders and Nyman, Ulf and Björk, Jonas and Lindström, Veronica and Rippe, Bengt and Sterner, Gunnar and Christensson, Anders},
  issn         = {0009-9147},
  keyword      = {Adolescent,Adult,Age Factors,Aged,Aged, 80 and over,Algorithms,Biomarkers/blood,Child,Child, Preschool,Cystatin C,Cystatins/blood,Female,Glomerular Filtration Rate,Humans,Infant,Infant, Newborn,Kidney/physiopathology,Kidney Diseases/diagnosis,Male,Mathematics,Middle Aged,Predictive Value of Tests,Sex Factors},
  language     = {eng},
  number       = {8},
  pages        = {1420--1431},
  publisher    = {American Association for Clinical Chemistry},
  series       = {Clinical Chemistry},
  title        = {Simple Cystatin C-Based Prediction Equations for Glomerular Filtration Rate Compared with the Modification of Diet in Renal Disease Prediction Equation for Adults and the Schwartz and the Counahan-Barratt Prediction Equations for Children.},
  url          = {http://dx.doi.org/10.1373/clinchem.2005.051557},
  volume       = {51},
  year         = {2005},
}