Concordance between creatinine- and cystatin C-based eGFR in clinical practice
| Autor: | Joanna A.E. van Wijk, Emil den Bakker, Isabelle Hubeek, R. J. B. J. Gemke, Marin Musters, Arend Bökenkamp |
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| Přispěvatelé: | Pediatric surgery, Clinical chemistry, ACS - Microcirculation, Amsterdam Reproduction & Development (AR&D), APH - Health Behaviors & Chronic Diseases, APH - Methodology |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Concordance Clinical Biochemistry Population 030232 urology & nephrology Urology Patient characteristics 030204 cardiovascular system & hematology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine medicine Pediatric nephrology Outpatient clinic Humans Cystatin C Practice Patterns Physicians' education Child Creatinine education.field_of_study biology business.industry General Medicine Clinical Practice chemistry biology.protein Female business Glomerular Filtration Rate |
| Zdroj: | Scandinavian Journal of Clinical and Laboratory Investigation, 81(2), 142-146. Informa Healthcare den Bakker, E, Musters, M, Hubeek, I, van Wijk, J A E, Gemke, R J B J & Bokenkamp, A 2021, ' Concordance between creatinine-and cystatin C-based eGFR in clinical practice ', Scandinavian Journal of Clinical and Laboratory Investigation, vol. 81, no. 2, pp. 142-146 . https://doi.org/10.1080/00365513.2021.1871776 |
| ISSN: | 0036-5513 |
| Popis: | The mean of GFR-estimates based on serum creatinine (eGFRcrea) and cystatin C (eGFRcys) has superior accuracy than each estimate alone. Recent studies have shown that agreement between eGFRcrea and eGFRcys is an indicator for the accuracy of the mean of the two estimates. As long as the difference between the two (|ΔeGFR|) is below 40%, a high P30 accuracy rate of more than 90% was documented in research settings using gold-standard GFR measurements. This was the case in approximately 80% of the measurements. The study was set out to explore |ΔeGFR| in a broader pediatric nephrological population and identify factors influencing the discrepancy between eGFRcrea and eGFRcys. We retrospectively analyzed 1596 simultaneous cystatin C and creatinine measurements in 649 unique patients at the pediatric nephrology outpatient clinic of VU university medical center. The FASage equation was used to calculate eGFRcrea, FAScys for eGFRcys. |ΔeGFR| was calculated as 100x(|eGFRcrea-eGFRcys|)/(0.5x(eGFRcrea+eGFRcys). ΔeGFR below 40% was considered high agreement. Patient characteristics like age, diagnosis, glucocorticosteroid use, eGFR, BMI and sex were analyzed for their effect on ΔeGFR below or above 40% using non-parametric tests and a potential explanation for measurements with low agreement was sought. Eighty-seven percent of the population had a |ΔeGFR| lower than 40%. Measurements with |ΔeGFR| above 40% were significantly more frequent from patients with neural tube defects. In 102 out of 208 measurements with low agreement, a potential explanation was found. In a broad pediatric nephrological population, |ΔeGFR| is below 40% in the vast majority of measurements. In this group, the mean of eGFRcrea and eGFRcys can be used as an accurate estimate of GFR. |
| Databáze: | OpenAIRE |
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