The chronic kidney disease epidemiology collaboration equation combining creatinine and cystatin C accurately assesses renal function in patients with cirrhosis

BMC Nephrology

Research Article

Alexander R. Rosenkranz¹  Katharina Artinger¹  Sabine Zitta¹  Günter Fauler²  Tatjana Stojakovic²  Daniela Kniepeiss³  Doris Wagner⁴  Vanessa Stadlbauer⁵  Gernot Zollner⁵  Franziska Durchschein⁵  Elisabeth Krones⁵  Peter Fickert⁵  Rudolf Stauber⁵  Stefan Neunherz⁶  Gilbert Reibnegger⁷ 

[1] Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria;Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria;Department of Surgery, Division of Transplant Surgery, Medical University of Graz, Graz, Austria;Division for General Surgery, Department of Surgery, Medical University of Graz, Graz, Austria;Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria;Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria;Department of Cardiology, Klinikum Leverkusen, Leverkusen, Germany;Institute for Physiological Chemistry, Medical University of Graz, Graz, Austria;

关键词: Cirrhosis;    Cystatin C;    Glomerular filtration rate;    Renal function;    Clearance;    Sinistrin;   

DOI  :  10.1186/s12882-015-0188-0

 received in 2015-07-15, accepted in 2015-11-13,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAccurate measurement of renal function in cirrhotic patients is still challenging. To find the best test for the determination of the true glomerular filtration rate (GFR) in cirrhotic patients this study prospectively compared measured (m)GFR, the gold standard, with estimated (e)GFR using equations based on serum levels of creatinine and cystatin C.MethodsGFR was measured by sinistrin clearance using the bolus method in 50 patients with cirrhosis (Child Turcotte Pugh score A, B and C) and 24 age-matched healthy subjects as controls. Measured (m)GFR was compared to eGFR using bias, accuracy 10 % and 30 %, as well as correlation coefficients.ResultsCreatinine-based equations generally overestimated GFR in patients with cirrhosis and showed a bias (average difference between mGFR and eGFR) of −40 (CG), −12 (MDRD) and −9 (CKD-EPI-Cr) ml/min/1.73 m2. Cystatin C-based equations underestimated GFR, especially in patients with Child Turcotte Pugh score C (bias 17 ml/min/1.73 m2for CKD-EPI-CysC). Of these equations, the CKD-EPI equation that combines creatinine and cystatin C (CKD-EPI-Cr-CysC) showed a bias of 0.12 ml/min/1.73 m2 as compared to measured GFR.ConclusionsThe CKD-EPI equation that combines serum creatinine and cystatin C measurements shows the best performance for accurate estimation of GFR in cirrhosis, especially at advanced stages.

【 授权许可】

CC BY   
© Krones et al. 2015