Korean J Lab Med.  2007 Feb;27(1):34-39. 10.3343/kjlm.2007.27.1.34.

Assessment of the Accuracy and Precision of Cystatin C-based GFR Estimates and Cr-based GFR Estimates in Comparison with Cr51-EDTA GFR

• Kim Y
• Min WK
• Rhew J

• KMID: 1121657
• DOI: http://doi.org/10.3343/kjlm.2007.27.1.34

Abstract

BACKGROUND: Cystatin C (cysC) is said to be an ideal marker for glomerular filtration rate (GFR), independent of external factors such as age, nutrition and inflammation. The authors compared the accuracy and precision of cysC-based and creatinine (Cr)-based GFR estimates using Cr51-EDTA GFR method as a reference. METHODS: Serum concentrations of cysC and Cr were measured in adults over 17 yr (n=170) and children below 17 yr (n=79) who had had GFR estimated by Cr51-EDTA method. CysC-based GFR was estimated by the formula of Thierry [CysC-based GFR estimates (mL/min/1.73 m2)=78 x (1/cysC, in mg/L)+4] and Cr-based GFR by the formula of modified Modification of Diet in Renal Disease [MDRD II, Cr-based GFR estimates (mL/min/1.73 m2)=186 x (Scr)(-1.154) x (Age)(-0.203) x 0.742 (for a female patient) x 1.212 (for a black patient). RESULTS: In comparison with Cr51-EDTA GFR, in children below 17 yr, the bias +/- standard deviation (SD) of cysC-based and Cr-based GFR estimates were 7.5 +/- 6.1 and 106.5 +/- 98.2, respectively, in the range of below 90 of Cr51-EDTA GFR (mL/min/1.73 m2), and 33.7 +/- 33.0 and 174.4 +/- 18.8 in the range of over 90. In adults over 17 yr, the respective figures were 13.1 +/- 11.0 and 17.4 +/- 29.8 in below 90, and 21.2 +/- 20.1 and 83.6 +/- 108.8 in over 90 of Cr51-EDTA GFR. CONCLUSIONS: CysC-based GFR estimates show acceptable ranges of biases over the whole age and GFR ranges. CysC-based GFR estimates is considered to be the marker for GFR, which could be used without limitation of age and GFR ranges.

Keyword

Cr51-EDTA GFR; Cystatin C-based GFR estimates; Creatinine-based GFR estimates

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Biological Markers/urine
Child
Chromium Radioisotopes/diagnostic use
Creatinine/*urine
Cystatin C
Cystatins/*urine
Edetic Acid/diagnostic use
Female
Glomerular Filtration Rate/*physiology
Humans
Male
Middle Aged
Organometallic Compounds/diagnostic use

Figure

• 

  Fig. 1. The scatter plot of cystatin C-based GFR estimates (A) and creatinine-based GFR estimates (B) in comparison with Cr51-EDTA GFR.

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  Fig. 2. The mean bias±standard deviation (SD) of Cystatin C-based GFR estimates (A) and Cr-based GFR estimates (B) according to the age groups. Solid circle indicates mean bias in each age group and the length of solid line connecting horizontal solid lines indicates the extent of SD in each group. Cystatin C-based GFR estimates showed the bias less than 30 in the range of 0–99 age groups in contrast to Cr-based GFR estimates showing the bias less than 30 in the range of 20–69 age groups only.

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  Fig. 3. The mean bias±standard deviation (SD) of Cystatin C-based GFR estimates (A) and Cr-based GFR estimates (B) according to Cr51-EDTA GFR groups. Solid circle indicates mean bias in each Cr51-EDTA GFR group and the length of solid line connecting horizontal solid lines indicates the extent of SD in each group. Cystatin C-based GFR estimates showed the bias less than 30 in the range of 51Cr-EDTA GFR 0–119 (mL/min/1.73 m2) groups in contrast to Cr-based GFR estimates showing the bias less than 30 in the range of 51Cr-EDTA GFR 0–59 (mL/min/1.73 m2) groups only.

Reference

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