Comparison of glomerular filtration rate estimating equations derived from creatinine and cystatin C: validation in the Age, Gene/Environment Susceptibility-Reykjavik elderly cohort.
Jonas Björk,Anders Grubb,Vilmundur Gudnason,Olafur S. Indridason,Andrew S. Levey,Runolfur Palsson,Ulf Nyman +6 more
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TL;DR: None of the creatinine-based equations was clearly superior overall in this community-dwelling elderly cohort, but the addition of cystatin C improved all of theCreatinine -based equations.
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Abstract: Background. Validation studies comparing glomerular filtration rate (GFR) equations based on standardized creatinine and cystatin C assays in the elderly are needed. The Icelandic Age, Gene/Environment Susceptibility-Kidney cohort was used to compare two pairs of recently developed GFR equations, the revised Lund-Malmo creatinine equation (LMRCr) and the arithmetic mean of the LMRCr and Caucasian, Asian, Paediatric and Adult cystatin C equations (MEANLMRþCAPA), as well as the Full Age Spectrum creatinine equation (FASCr) and its combination with cystatin C (FASCrþCys), with the corresponding pair of Chronic Kidney Disease Epidemiology Collaboration equations (CKD-EPICr and CKD-EPICrþCys). Methods. A total of 805 individuals, 74-93 years of age, underwent measurement of GFR (mGFR) using plasma clearance of iohexol. Four metrics were used to compare the performance of the GFR equations: bias, precision, accuracy [including the percentage of participants with estimated GFR (eGFR) within 30% of mGFR (P30)] and the ability to detect mGFR 90%. LMRCr and FASCr yielded significantly higher precision and P30 than CKD-EPICr, while bias was significantly worse. LMRCr, FASCr and CKD-EPICr showed similar ability to detect mGFR <60 mL/min/1.73 m2 based on the area under the receiver operating characteristic curves. MEANLMRþCAPA, FASCrþCys and CKD-EPICrþCys all exhibited consistent improvements compared with the corresponding creatinine-based equations. Conclusion. None of the creatinine-based equations was clearly superior overall in this community-dwelling elderly cohort. The addition of cystatin C improved all of the creatinine-based equations. (Less)
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KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.
Paul E. Stevens,Sofia B. Ahmed,Juan-Jesús Carrero,Bethany Foster,Anna Francis,Rasheeda K. Hall,Will G. Herrington,Guy Hill,Lesley A. Inker,Rumeyza Kazancioglu,Edmund Lamb,Peter Lin,Magdalena Madero,Natasha McIntyre,Kelly Morrow,Glenda Roberts,Dharshana Sabanayagam,Elke Schaeffner,Michael Shlipak,Rukshana Shroff,Navdeep Tangri,Teerawat Thanachayanont,Ifeoma Ulasi,Germaine Wong,Chih-Wei Yang,Luxia Zhang,Adeera Levin +26 more
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Estimated GFR: time for a critical appraisal.
Esteban Porrini,Esteban Porrini,Piero Ruggenenti,Sergio Luis-Lima,Sergio Luis-Lima,Fabiola Carrara,Alejandro Jiménez,Aiko P. J. de Vries,Armando Torres,Armando Torres,Flavio Gaspari,Giuseppe Remuzzi,Giuseppe Remuzzi +12 more
TL;DR: It is argued that the persistence of errors in GFR estimation formulae indicates an inadequacy of serum creatinine and cystatin C levels as markers of actual renal function, rather than with the mathematical methods used for G FR estimation.
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Measured and estimated glomerular filtration rate: current status and future directions.
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Cystatin C-Based Equation to Estimate GFR without the Inclusion of Race and Sex.
Hans Pottel,Jonas Björk,Andrew D. Rule,Natalie Ebert,Bjørn Odvar Eriksen,Laurence Dubourg,Emmanuelle Vidal-Petiot,Anders Grubb,Magnus Hansson,Edmund J. Lamb,Karin Littmann,Christophe Mariat,Toralf Melsom,Elke Schaeffner,Per O Sundin,Anna Akesson,Anders Larsson,Etienne Cavalier,Justine B. Bukabau,Ernest Kiswaya Sumaili,Eric Yayo,D. Monnet,Martin Flamant,Ulf Nyman,Pierre Delanaye +24 more
TL;DR: In this article , the rescaling factor for the cystatin C level in adults was estimated based on data from 227,643 patients in Sweden, and the EKFC eGFRcys equation was validated in cohorts of White patients and Black patients in Europe, the United States, and Africa.
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GFR in Healthy Aging: an Individual Participant Data Meta-Analysis of Iohexol Clearance in European Population-Based Cohorts.
Bjørn Odvar Eriksen,Bjørn Odvar Eriksen,Runolfur Palsson,Natalie Ebert,Toralf Melsom,Toralf Melsom,Markus van der Giet,Vilmundur Gudnason,Olafur S. Indridasson,Lesley A. Inker,Trond Jenssen,Trond Jenssen,Andrew S. Levey,Marit Dahl Solbu,Marit Dahl Solbu,Hocine Tighiouart,Hocine Tighiouart,Elke Schaeffner +17 more
TL;DR: It is suggested that healthy aging is not associated with preserved GFR in old age, as both the mean and 97.5 percentiles of the GFR distribution are lower in older persons who are healthy than in middle-aged persons who is healthy.
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References
Age, Gene/Environment Susceptibility–Reykjavik Study: Multidisciplinary Applied Phenomics
Tamara B. Harris,Lenore J. Launer,Gudny Eiriksdottir,Olafur Kjartansson,Palmi V. Jonsson,Gunnar Sigurdsson,Gudmundur Thorgeirsson,Thor Aspelund,Melissa E. Garcia,Mary Frances Cotch,Howard J. Hoffman,Vilmundur Gudnason +11 more
TL;DR: The AGES-Reykjavik cohort, with cardiovascular risk factor assessments earlier in life and detailed late-life phenotypes of quantitative traits, will create a comprehensive study of aging nested in a relatively genetically homogeneous older population.
636
Two Novel Equations to Estimate Kidney Function in Persons Aged 70 Years or Older
Elke Schaeffner,Natalie Ebert,Pierre Delanaye,Ulrich Frei,Jens Gaedeke,Olga Jakob,Martin K. Kuhlmann,Mirjam Schuchardt,Markus Tölle,Reinhard Ziebig,Markus van der Giet,Peter Martus +11 more
TL;DR: The BIS2 equation should be used to estimate GFR in persons aged 70 years or older with normal or mild to moderately reduced kidney function, and if cystatin C is not available, the BIS1 equation is an acceptable alternative.
An estimated glomerular filtration rate equation for the full age spectrum
Hans Pottel,Liesbeth Hoste,Laurence Dubourg,Natalie Ebert,Elke Schaeffner,Bjørn Odvar Eriksen,Toralf Melsom,Edmund J. Lamb,Andrew D. Rule,Stephen T. Turner,Richard J. Glassock,Vandréa De Souza,Luciano Selistre,Christophe Mariat,Frank Martens,Pierre Delanaye +15 more
TL;DR: The new FAS equation has improved validity and continuity across the full age-spectrum and overcomes the problem of implausible eGFR changes in patients which would otherwise occur when switching between more age-specific equations.
First certified reference material for cystatin C in human serum ERM-DA471/IFCC.
Anders Grubb,Søren Blirup-Jensen,Veronica Lindström,Camilla Schmidt,Harald Althaus,Ingrid Zegers +5 more
TL;DR: The IFCC Working Group for the Standardisation of Cystatin C (WG-SCC), in collaboration with the Institute for Reference Materials and Measurements (IRMM), announces the availability of the new certified reference material ERM-DA471/IFCC, characterised using a pure protein primary reference preparation (PRP) as calibrant.
382
Generation of a New Cystatin C–Based Estimating Equation for Glomerular Filtration Rate by Use of 7 Assays Standardized to the International Calibrator
Anders Grubb,Masaru Horio,Lars-Olof Hansson,Jonas Björk,Ulf Nyman,Mats Flodin,Anders Larsson,Arend Bökenkamp,Yoshinari Yasuda,Hester N. Blufpand,Veronica Lindström,Ingrid Zegers,Harald Althaus,Søren Blirup-Jensen,Yoshi Itoh,Per Sjöström,Gunnar Nordin,Anders Christensson,Horst Klima,Kathrin Sunde,Per Hjort-Christensen,David Armbruster,Carlo A. Ferrero +22 more
TL;DR: A virtually assay-independent simple cystatin C-based and biologically oriented equation for estimation of GFR, without terms for sex and race, was produced.
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