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KMID : 0359920140330010045
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Korean Journal of Nephrology
2014 Volume.33 No. 1 p.45 ~ p.51
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Comparison of glomerular ?ltration rates calculated by different serum cystatin C-based equations in patients with chronic kidney disease
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Lee Hee-Sun
Rhee Ha-Rin
Seong Eun-Young
Lee Dong-Won
Lee Soo-Bong
Kwak Ihm-Soo
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Abstract
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Background: We aimed to evaluate the performance of serum cystatin C-based equations in calculating the glomerular ?ltration rate (GFR) in patients with varying stages of chronic kidney disease (CKD).
Methods: Serumcystatin C and creatinine levels were measured in 615 CKD patients. The CKD stage was determined by the creatinine-based estimated GFR (eGFR) equation using the four-variable abbreviated Modi?cation of Diet in Renal Disease equation suggested by the Kidney Disease Outcome Quality Initiative with the addition of a coef?cient applicable to Korean populations (K-aMDRD). In each CKD stage, the ratio of serum cystatin C to creatinine was calculated and six different cystatin C-based equations were used to estimate GFR. Cystatin C-based eGFR and aMDRDeGFR values were compared using the paired t test, Pearson correlation test, and the Bland?Altman plot.
Results: The mean age of patients was 53.21714.45 years; of the 615 patients, 346 were male. The serum cystatin C-to-creatinine ratio was inversely correlated with the CKD stage. Compared with the K-aMDRD values, the results of the Hoek, Filler, and Le Bricon’scystatin C-based eGFR equations were lower in CKD Stages 1?3 and higher in Stages 4 and 5. However, the results of the Orebro-cystatin (Gentian) equation [GFR¼100/ScytC (mL/minute/1.73m2) ? 14] were similar to those of the K-aMDRD equation in CKD Stages 4 and 5 (15.4479.45 vs. 15.1779.05mL/minute/ 1.73m2, respectively; P¼0.722; bias¼0.2778.87).
Conclusion: TheeGFRs obtained from the six cystatin C-based equations differed widely. Therefore, further studies are required to determine the most accurate equation to estimate GFR in Koreans with CKD.
& 2014.The Korean Society of Nephrology.Published by Elsevier. All rights reserved.
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KEYWORD
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Chronic kidneydisease, Cystatin C, Estimated glomerular filtration rate, Serum creatinine
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