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Cystatin C-based glomerular filtration rate estimating equations in early chronic kidney disease

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Abstract

Objective

To Compare performance of combined creatinine and cystatin C-based equation with equations based on either cystatin C or creatinine alone, in early chronic kidney disease.

Design

Diagnostic accuracy study.

Setting

Tertiary-care hospital.

Patients

One hundred children with chronic kidney disease who underwent 99mTc diethylenetriamine pentaacetic acid (DTPA) glomerular filtration rate measurement.

Methods

Estimating equations for glomerular filtration rate (GFR) based on serum cystatin C alone and in combination with serum creatinine were generated using regression analyses. These equations and the creatinine-based equation [0.42 × height/creatinine] were validated in 42 children with glomerular filteration rate between 60 and 90 mL/min/1.73 m2. Bias, precision and accuracy of estimating equations using DTPA glomerular filteration rate as gold standard.

Results

Cystatin C-based equation (GFR=96.9–30.4 x cystatin) overestimated while the combined cystatin C-and creatininebased equation [GFR=11.45 x (height/creatinine) 0.356 x (1/cystatin) 0.188] underestimated the measured GFR. Cystatin Cbased equation had less bias (1.9 vs. 12.4 ml/min/1.73 m2), and higher precision (13.1 vs. 25.6 mL/min/1.73 m2) and accuracy (92.1% vs. 75.7%) than creatinine-based equation. The combined cystatin C and creatinine equation had bias (−1.4 mL/ min/1.73 m2) precision (15.2 mL/min/1.73 m2) and accuracy (91.2%) similar to cystatin C-based equation.

Conclusions

Cystatin C-based equation has a better performance in estimating glomerular filtration rate than creatinine-based equation in children with early chronic kidney disease. Addition of creatinine equation does not improve the performance of the cystatin C-based equation.

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Authors and Affiliations

  1. Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

    Pankaj Hari & Arvind Bagga

  2. Department of Cardiac Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

    Lakshmy Ramakrishnan & Ruby Gupta

  3. Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

    Rakesh Kumar

  4. Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India

    Pankaj Hari

Authors
  1. Pankaj Hari
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  2. Lakshmy Ramakrishnan
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  3. Ruby Gupta
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  4. Rakesh Kumar
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  5. Arvind Bagga
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Correspondence to Pankaj Hari.

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Hari, P., Ramakrishnan, L., Gupta, R. et al. Cystatin C-based glomerular filtration rate estimating equations in early chronic kidney disease. Indian Pediatr 51, 273–277 (2014). https://doi.org/10.1007/s13312-014-0400-5

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  • DOI: https://doi.org/10.1007/s13312-014-0400-5

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