Assessment of creatinine and cystatin C-based eGFR equations in Chinese older adults with chronic kidney disease

作者：Guan, Changjie; Liang, Ming; Liu, Riguang; Qin, Shuguang; He, Feng; Li, Jianwen; Zhu, Xusheng; Dai, Hui; Fu, Junzhou^*

来源：International Urology and Nephrology, 2018, 50(12): 2229-2238.

DOI：10.1007/s11255-018-1909-7

• Glomerular filtration rate
• Equation
• Older adults
• Chronic kidney disease
• Creatinine
• Cystatin-C

IntroductionGlomerular filtration rate (GFR) estimation equations using creatinine and Cystatin-C appear to be superior to those based on creatinine or Cystatin-C in older adults. We sought to compare the performances of those based on creatinine and Cystatin-C in Chinese older adults with chronic kidney disease (CKD).MethodsA total of 368 Chinese elderly with CKD underwent the dynamic imaging with technetium-(99)m diethylene-triamine-pentaacetic acid ((99)mTc-DTPA), and serum creatinine and Cystatin-C were measured on the same day. The comparison of GFR equations which were creatinine and Cystatin-C-based including chronic kidney disease epidemiology collaboration (CKD-EPI) equation (CKD-EPI-Cr-Cys), Berlin Initiative Study (BIS) equation (BIS-Cr-Cys, also known as BIS-2), MA equation (MA-Cr-Cys), and FENG equation (FENG-Cr-Cys) was conducted.ResultsFour equations overestimated GFR except for BIS-2 equation in mGFR60ml/min/1.73m(2) (bias: -1.40, p=0.7) and CKD-EPI-Cr-Cys equation in mGFR<30ml/min/1.73m(2) (bias: -1.82, p=0.2) were unbiased. BIS-2 equation had the smallest interquartile range (IQR, ml/min/1.73m(2)) from 12.73 in age<75years group to 16.05 in age75years group. BIS-2 equation achieved highest values of 79.1% in overall participants, and 80.77% in age75years group, respectively, and CKD-EPI-Cr-Cys equation82.26% in age<75years group. Lowest values of root-mean-square error (RMSE, ml/min/1.73m(2)) were seen in BIS-2 equation from 13.22 in age<75years group to 16.18 in age75years group. BIS-2 equation had the lowest misclassification rates of 41.76% in age75years group and 34.41% in age<75years group.ConclusionsBIS-2 equation may be optimal for Chinese older adults with CKD especially in older adults75years and with mGFR30ml/min/1.73m(2), while CKD-EPI-Cr-Cys equation could yield a better performance than BIS-2 equation, especially in those<75years and mGFR<30ml/min/1.73m(2).

• 出版日期2018-12
• 单位广州医科大学