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Different equations to combine creatinine and cystatin C to predict GFR. Arithmetic mean of existing equations performs as well as complex combinations

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Author

Summary, in English

Purpose: To test various ways of combining creatinine and cystatin C in equations to predict glomerular filtration rate (GFR). Material and methods: Performance of the following expressions to predict GFR was compared with measured GFR (iohexol clearance, mL/min/1.73 m(2)) in 857 patients: (i) Lund-Malmo creatinine equation, (ii) Grubb cystatin C equation, (iii) arithmetic mean of (1) and (2), (iv) geometric mean of (1) and (2), (v) linear regression on (1) and (2), (vi) regression on (1) and cystatin C, and (vii) regression on creatinine, cystatin C, age and gender. Results: For the entire cohort median percent error (bias) was <5% for all expressions, though all expressions tended to underestimate (<8.3 to <15.8%) GFR at levels <90 mL/min/1.73 m(2). The five expressions combining creatinine and cystatin C significantly improved correlation and accuracy (p < 0.001) within 15 and 30% of measured GFR compared with the equations based on the separate analytes and with no significant difference between the five expressions. In a subgroup of patients with neurological disease and muscle atrophy the cystatin C equation performed better than the expressions combining creatinine and cystatin C. Conclusion: Simply calculating the arithmetic mean of predicted GFR based on separate creatinine and cystatin C equations performs equally well as more complex equations. Reporting GFR based on separate creatinine and cystatin C equations, and their arithmetic mean also has the definite advantage that the physician can choose the estimated GFR, most appropriate depending on the clinical setting and patient characteristics.

Publishing year

2009

Language

English

Pages

619-627

Publication/Series

Scandinavian Journal of Clinical & Laboratory Investigation

Volume

69

Issue

5

Document type

Journal article

Publisher

Informa Healthcare

Topic

  • Pharmacology and Toxicology
  • Other Clinical Medicine
  • Environmental Health and Occupational Health
  • Medicinal Chemistry

Keywords

  • glomerular filtration rate
  • Kidney disease
  • kidney function tests
  • renal insufficiency

Status

Published

Research group

  • Internal Medicine - Epidemiology

ISBN/ISSN/Other

  • ISSN: 1502-7686