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Comparison of estimated glomerular filtration rate equations based on serum creatinine-, cystatin C- and creatinine–cystatin C in elderly Chinese patients

  • Nephrology - Original Paper
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Abstract

Background

This study aimed to further evaluate the accuracy of eleven GFR equations in different subgroups of an elderly Chinese hospitalized population.

Methods

All participants of the study were divided into seven separate groups including age-subgroup, sex-subgroup, GFR Staging-subgroup and whether combined with diabetic, hypertensive, coronary heart disease (CHD) and cerebrovascular disease. Referring to Tc-99m-DTPA dual plasma sample clearance method, six serum creatinine (Cr)-based [Cockcroft–Gault (CG), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPICr), Lund-Malmö Revised (LMR), Berlin Initiative Study (BIS1), Full Age Spectrum (FASCr) and European Kidney Function Consortium (EKFC)], two serum cystatin C(Cys)-based (CKD-EPICys and FASCys), and three Cr-Cys combination based (CKD-EPICr-Cys, BIS2 and FASCr-Cys) equations were employed. Bias, interquartile range of the median difference (IQR), P30, and GFR misclassification rate were calculated to compare the performance of the selected equations.

Results

A total of 359 elderly Chinese patients were enrolled. Overall, median mGFR was 36.91(25.26,56.32)ml/min/1.73 m2. Smaller biases (ml/min/1.73 m2) were shown in CKD-EPICr and BIS1 equations (0.75 and 0.61). IQR (ml/min/1.73m2) was least with BIS2 equation and FASCr-Cys equation (10.34 and 10.65). For accuracy (P30), performance of FASCr-Cys, BIS2, and BIS1 equation was superior (78.3%, 78.0%, and 74.7%, respectively). In terms of RMSE (ml/min/1.73 m2), BIS1 and FASCr-Cys equation performed better (12.44 and 12.51).

Conclusions

Overall, this study showed that the eGFR equations were less accurate in the diabetic and non-hypertension group than in the non-diabetic and hypertension group, respectively. Among all enrolled equations, the BIS2 and FASCr-Cys equations might be the best choice to evaluate glomerular filtration rate in Chinese elderly patients.

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Acknowledgements

This study was supported by National Natural Science Foundation of China for Young Scholars [82100711], NSFC Incubation Program of GDPH [8197052558 and KY012021155], Medical Scientific Research Foundation of Guangdong Province, China [A2021442] and Natural Science Foundation of Guangdong Province [2018A0303130251].

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Author notes

  1. Fangxiao Xia and Wenke Hao are considered as co-first authors.

Authors and Affiliations

  1. Department of Geriatric Nephrology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, 510080, China

    Fangxiao Xia, Wenke Hao, Jinxiu Liang, Zhi Zhao, Yanhua Wu, Feng Yu, Wenxue Hu, Xiaowu Fang & Wei Liu

  2. The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China

    Fangxiao Xia, Jinxiu Liang & Wei Liu

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  1. Fangxiao Xia
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Correspondence to Wei Liu.

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Conflict of interest

The authors declared that they had no conflict of interest.

Ethical approval

It was approved by the Research Ethics Committee of Guangdong Provincial People’s Hospital, registration number KY-Q-2021–189-01.

Informed consent

Participants in the study signed an informed consent form and admission notice that the hospitalization information could be used for the clinical study when they went through the admission procedures.

Research involves human and animal rights

This observational cross-sectional study has been performed in accordance with the ethical standards stated in the Declaration of Helsinki (1964). No animals were involved.

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Xia, F., Hao, W., Liang, J. et al. Comparison of estimated glomerular filtration rate equations based on serum creatinine-, cystatin C- and creatinine–cystatin C in elderly Chinese patients. Int Urol Nephrol 55, 943–952 (2023). https://doi.org/10.1007/s11255-022-03370-7

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