Estimating glomerular filtration rate in diabetes: a comparison of cystatin-C- and creatinine-based methods
We compared the predictive performance of a GFR based on serum cystatin C levels with commonly used creatinine-based methods in subjects with diabetes.
Subjects, materials and methods
In a cross-sectional study of 251 consecutive clinic patients, the mean reference (plasma clearance of 99mTc-diethylene-triamine-penta-acetic acid) GFR (iGFR) was 88±2 ml min−1 1.73 m−2. A regression equation describing the relationship between iGFR and 1/cystatin C levels was derived from a test population (n=125) to allow for the estimation of GFR by cystatin C (eGFR-cystatin C). The predictive performance of eGFR-cystatin C, the Modification of Diet in Renal Disease 4 variable formula (MDRD-4) and Cockcroft–Gault (C–G) formulas were then compared in a validation population (n=126).
There was no difference in renal function (ml min−1 1.73 m−2) as measured by iGFR (89.2±3.0), eGFR-cystatin C (86.8±2.5), MDRD-4 (87.0±2.8) or C–G (92.3±3.5). All three estimates of renal function had similar precision and accuracy.
Estimates of GFR based solely on serum cystatin C levels had the same predictive potential when compared with the MDRD-4 and C–G formulas.
- Filler G, Bokenkamp A, Hofmann W, Le Bricon T, Martinez-Bru C, Grubb A (2005) Cystatin C as a marker of GFR history, indications, and future research. Clin Biochem 38:1–8 CrossRef
- Hoek FJ, Kemperman FA, Krediet RT (2003) A comparison between cystatin C, plasma creatinine and the Cockcroft and Gault formula for the estimation of glomerular filtration rate. Nephrol Dial Transplant 18:2024–2031 CrossRef
- Premaratne E, MacIsaac RJ, Tsalamandris C, Panagiotopoulos S, Smith T, Jerums G (2005) Renal hyperfiltration in type 2 diabetes: effect of age related decline in GFR. Diabetologia 48:2486–2493 CrossRef
- Mathew T on behalf of the Australasian Creatinine Consensus Working Group (2005) Chronic kidney disease and automatic reporting of estimated glomerular filtration rate: a position statement. Med J Aust 183:138–141
- Jenkins MA, Brown DJ, Ierino FL, Ratnaike SI (2003) Cystatin C for estimation of glomerular filtration rate in patients with spinal cord injury. Ann Clin Biochem 40:364–368 CrossRef
- Manjunath G, Sarnak MJ, Levey AS (2001) Prediction equations to estimate glomerular filtration rate: an update. Curr Opin Nephrol Hypertens 10:785–792 CrossRef
- Poggio ED, Wang X, Greene T, Van Lente F, Hall PM (2005) Performance of the modification of diet in renal disease and Cockcroft–Gault equations in the estimation of GFR in health and in chronic kidney disease. J Am Soc Nephrol 16:459–466 CrossRef
- Perkins BA, Nelson RG, Ostrander BE et al (2005) Detection of renal function decline in patients with diabetes and normal or elevated GFR by serial measurements of serum cystatin C concentration: results of a 4-year follow-up study. J Am Soc Nephrol 16:1404–1412 CrossRef
- Wasen E, Isoaho R, Mattila K, Vahlberg T, Kivela SL, Irjala K (2003) Serum cystatin C in the aged: relationships with health status. Am J Kidney Dis 42:36–43 CrossRef
- Shlipak MG, Sarnak MJ, Katz R et al (2005) Cystatin C and the risk of death and cardiovascular events among elderly persons. N Engl J Med 352:2049–2060 CrossRef
- Estimating glomerular filtration rate in diabetes: a comparison of cystatin-C- and creatinine-based methods
Volume 49, Issue 7 , pp 1686-1689
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Cystatin C
- Diabetic nephropathy
- Glomerular filtration rate
- Renal insufficiency
- Industry Sectors
- Author Affiliations
- 1. Endocrine Centre and the Department of Medicine, Austin Health and University of Melbourne, Heidelberg Repatriation Hospital, Level 2, Centaur Building, Heidelberg West, VIC, 3081, Australia
- 2. Danielle Alberti Memorial Centre for Diabetes Complications, Baker Medical Research Institute, Melbourne, VIC, Australia
- 3. Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, VIC, Australia
- 4. Division of Laboratory Medicine, Austin Health, Heidelberg, VIC, Australia
- 5. Department of Nephrology, Austin Health, Heidelberg, VIC, Australia