1
|
Potok A, Rifkin D, IX J, Shlipak M, Satish A, Schneider A, Mielke N, Schaeffner E, Ebert N. MO373: How to Decide Whether Creatinine or Cystatin C is More Accurate for Kidney Function Assessment in Older Adults. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac069.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
The gold standard for evaluation of kidney function is measured GFR [mGFR] which is challenging to perform in clinical practice. Serum creatinine and cystatin C are used to estimate GFR clinically, but neither is a perfect marker. Within any given individual, the estimated glomerular filtration rate (eGFR) can be widely different when using serum creatinine [eGFRCr] vs. cystatin C [eGFRCys]. We investigated which was closest to mGFR in elderly outpatients when results between these two eGFRs were discrepant.
METHOD
About 657 older ambulatory participants of the population-based Berlin Initiative Study (BIS) had GFR measured by iohexol plasma clearance (mGFR), as well as serum creatinine and cystatin C levels. eGFRCr and eGFRCys were calculated using the 2009 and 2012 CKD-EPI equations, respectively. The cohort was divided into two groups based on which of these eGFR estimates was lowest. Bias (defined as ‘eGFR-mGFR’), imprecision (standard deviation [interquartile range] of bias), as well as proportion within 30% (P30) were calculated.
RESULTS
Mean (±SD) age was 78 (±6) years, eGFRCys was 59 (±23), mean eGFRCr was 64 (±20) and mGFR was 55 (±20) mL/min/1.73 m2. Mean (±SD) body mass index was 28 (4) kg/m2 58% were men, and 26% had diabetes mellitus. Two-thirds of participants (448/657 = 68%) had eGFRCys < eGFRCr. Regardless of which group participants were in, the lower of the two eGFR estimates was the one less biased compared to mGFR. Among those in whom eGFRCr ≤ eGFRCys, 80% (=168/209) had eGFRCr closer to mGFR than eGFRCys; among those in whom eGFRCys < eGFRCr, 74% (=333/448) had eGFRCys closer to mGFR than eGFRCr (Figure). P30 was 86% for eGFRCr when it was the lower estimate, and was 90% for eGFRCys when it was the lower estimate (Table).
CONCLUSION
In a population of community-dwelling older adults, the lower value between eGFRCys and eGFRCr was closest to mGFR in 76% of participants.
Collapse
Affiliation(s)
- Alison Potok
- University of California San Diego, La Jolla, CA, UK
| | - Dena Rifkin
- University of California San Diego, La Jolla, CA, UK
| | - Joachim IX
- University of California San Diego, La Jolla, CA, UK
| | - Michael Shlipak
- UCSF School of Medicine, Medicine, Epidemiology & Biostatistics, San Francisco, CA, UK
| | - Anita Satish
- University of California San Diego, La Jolla, CA, UK
| | - Alice Schneider
- Charité-Institut für Biometrie und Klinische Epidemiologie, Berlin, Germany
| | - Nina Mielke
- Charité-Institut für Public Health, Berlin, Germany
| | | | | |
Collapse
|
2
|
Joachim I, Reuschel J. [Catamnestic study of patients undergoing ambulatory surgery for hallux valgus and rigidus]. Beitr Orthop Traumatol 1987; 34:65-8. [PMID: 3579851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|