CKD-EPI creatinine-cystatin C glomerular filtration rate estimation equation seems more suitable for Chinese patients with chronic kidney disease than other equations

BMC Nephrology

Research Article

Yao-ming Xue¹  Qian Zhang¹  Quan-Shi Wang²  Kai Huang²  Xiao-Hua Chi²  Yong-Shuai Qi²  Gui-Ping Li² 

[1] Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, Guangdong, China;Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, Guangdong, China;

关键词: Serum creatinine;    Cystatin C;    Glomerular filtration rate;    Chronic kidney disease;   

DOI  :  10.1186/s12882-017-0637-z

 received in 2016-12-24, accepted in 2017-06-26,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe aim of this study was to identify the optimal equation that accurately estimates the glomerular filtration rate (GFR) and the chronic kidney disease (CKD) stage in the Chinese population.MethodsA total of 1296 Chinese patients aged 18–65 years old were enrolled in this study. The estimated GFRs (eGFRs) calculated separately by three Diet in Renal Disease (MDRD) equations and three Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations were compared with the reference GFR (rGFR) measured by the 99Tcm-DTPA renal dynamic imaging method.ResultsBy Bland-Altman analysis, eGFRcys and eGFRscr_cys performed similarly, showing the tightest limits of agreement among the six equations. They also achieved the first and second highest 30% and 50% accuracies. Using a combination of the serum creatinine and cystatin C levels (eGFRscr_cys) could improve the bias (−0.3 for eGFRscr_cys) of the equation and achieve the highest diagnostic accuracy for renal insufficiency (AUC60, 0.953; P < 0.05, except for eGFR_MDRD). All equations predicted stage 3 CKD with moderate accuracy (49.7–51.4%) and stage 5 CKD with good accuracy (90.2–96.4%). For stage 1 CKD, eGFRcys showed a higher percentage of misclassification than the other equations. All equations seemed to perform poorly at predicting stage 2 and 4 CKD, as compared to the other CKD stages. eGFRscr_cys was the best-performing equation in terms of accurate classification of the CKD stage based on the overall performance (kappa value, 0.423).ConclusionFor a Chinese population, the CKD-EPIscr_cys equation seems more suitable for estimating the GFR than the other equations. Each equation had its own advantages in predicting different CKD stages.

【 授权许可】

CC BY   
© The Author(s). 2017