New Combined Serum Creatinine and Cystatin C Quadratic Formula for GFR Assessment in Children
| Autor: | Dolores Mosig, Daniel Bardy, Blaise-Julien Meyrat, Anne-Sophie Jannot, Eric Girardin, Francois Cachat, Hassib Chehade, Paloma Maria Parvex |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Epidemiology Kidney urologic and male genital diseases Critical Care and Intensive Care Medicine Severity of Illness Index Correlation chemistry.chemical_compound Statistics Medicine Biological Markers/blood Child reproductive and urinary physiology ddc:618 biology Age Factors Models Cardiovascular Linear model female genital diseases and pregnancy complications Nephrology Creatinine Child Preschool Female Sinistrin Kidney/physiopathology Glomerular Filtration Rate Adolescent Correlation coefficient Cystatin C/blood Renal function Quadratic formula Predictive Value of Tests Humans Cystatin C Renal Insufficiency Chronic Transplantation business.industry Reproducibility of Results Original Articles Creatinine/blood Renal Insufficiency Chronic/blood/diagnosis/physiopathology Logistic Models chemistry Linear Models biology.protein business Biomarkers |
| Zdroj: | Clinical Journal of the American Society of Nephrology, Vol. 9, No 1 (2014) pp. 54-63 |
| ISSN: | 1555-9041 |
| DOI: | 10.2215/cjn.00940113 |
| Popis: | The estimated GFR (eGFR) is important in clinical practice. To find the best formula for eGFR, this study assessed the best model of correlation between sinistrin clearance (iGFR) and the solely or combined cystatin C (CysC)- and serum creatinine (SCreat)-derived models. It also evaluated the accuracy of the combined Schwartz formula across all GFR levels.Two hundred thirty-eight iGFRs performed between January 2012 and April 2013 for 238 children were analyzed. Regression techniques were used to fit the different equations used for eGFR (i.e., logarithmic, inverse, linear, and quadratic). The performance of each model was evaluated using the Cohen κ correlation coefficient and the percentage reaching 30% accuracy was calculated.The best model of correlation between iGFRs and CysC is linear; however, it presents a low κ coefficient (0.24) and is far below the Kidney Disease Outcomes Quality Initiative targets to be validated, with only 84% of eGFRs reaching accuracy of 30%. SCreat and iGFRs showed the best correlation in a fitted quadratic model with a κ coefficient of 0.53 and 93% accuracy. Adding CysC significantly (P0.001) increased the κ coefficient to 0.56 and the quadratic model accuracy to 97%. Therefore, a combined SCreat and CysC quadratic formula was derived and internally validated using the cross-validation technique. This quadratic formula significantly outperformed the combined Schwartz formula, which was biased for an iGFR≥91 ml/min per 1.73 m(2).This study allowed deriving a new combined SCreat and CysC quadratic formula that could replace the combined Schwartz formula, which is accurate only for children with moderate chronic kidney disease. |
| Databáze: | OpenAIRE |
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