Abstract
Background and aim: The aim of the study was to compare the agreement of the commonly used creatininebased equations with simple cystatin C (cysC) equation (100/serum cysC) for estimation of glomerular filtration rate (GFR) in Chinese postmenopausal women with normal or mildly decreased renal function. Materials and methods: Total 936 twenty-four-hour urine and 837 fasting serum samples were tested for creatinine and serum cysC. GFR was estimated by 10 creatinine based equations which included the CockcroftGault equation (CG), the Modification of Diet in Renal Disease equation (MDRD), the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI), 24 h urine creatinine clearance (CrCl), as well as six Asian equations (Asia, Japan, Korean, Thai, China1 and China2). The agreement of the creatinine based equations with cysC equation was assessed for correlation, bias, precision and accuracy. Results: The equations of Korea (r=0.784), China2 (r=0.694), CKD-EPI (r=0.686) and CG (r=0.676) indicated higher intra-correlation with simple cysC GFR than other equations. CG and Korean formulas showed minimal bias from cysC GFR. Bland and Altman plot suggested a significant smaller limit of agreement to cysC GFR was achieved by Japan (52.7%), CKD-EPI (39%), Korean (45.2%) and China2 (46.3%) equations than CrCl (106.8%). Receiver operating characteristic (ROC) analysis indicated the better predictive performance in CG, CKD-EPI and China2 equations to cysC equation. Conclusions: Estimation of GFR using the equations of CKD-EPI, Korean, China2 and Japan has comparable precision and accuracy with simple cysC calculated GFR among Chinese postmenopausal women with normal or mildly decreased renal function.
Highlights
Chronic kidney disease (CKD) is a worldwide health problem leading to a substantial risk for kidney failure, cardiovascular disease and mortality [1]
Estimation of glomerular filtration rate (GFR) using the equations of CKD-EPI, Korean, China2 and Japan has comparable precision and accuracy with simple cystatin C (cysC) calculated GFR among Chinese postmenopausal women with normal or mildly decreased renal function
Serum creatinine is commonly used as a surrogate marker for filtration function of kidney; its level can be affected by diet, muscle mass and tubular secretion
Summary
Chronic kidney disease (CKD) is a worldwide health problem leading to a substantial risk for kidney failure, cardiovascular disease and mortality [1]. Measurement of GFR is ideally performed using gold standards such as inulin, iohexol, 125I-iothalamate, 51Cr-EDTA or 99mTc DTPA clearance. Serum creatinine is commonly used as a surrogate marker for filtration function of kidney; its level can be affected by diet, muscle mass and tubular secretion. To overcome this deficiency, the Kidney Disease Outcome Quality Initiative (K/DOQI) recommended serum creatinine-based GFR equations with inclusion of demographic characteristics to estimate GFR [2]. The aim of the study was to compare the agreement of the commonly used creatininebased equations with simple cystatin C (cysC) equation (100/serum cysC) for estimation of glomerular filtration rate (GFR) in Chinese postmenopausal women with normal or mildly decreased renal function
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