Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10381
Title: Comparison of creatinine and cystatin C based eGFR in the estimation of glomerular filtration rate in Indigenous Australians: The eGFR Study.
Authors: Barr, Elizabeth Lm
Maple-Brown, Louise J
Barzi, Federica
Hughes, Jaquelyne T
Jerums, George
Ekinci, Elif I
Ellis, Andrew G
Jones, Graham Rd
Lawton, Paul D
Sajiv, Cherian
Majoni, Sandawana W
Brown, Alex Dh
Hoy, Wendy E
O'Dea, Kerin
Cass, Alan
MacIsaac, Richard J
Affiliation: Menzies School of Health Research, Darwin, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Australia. Electronic address: Elizabeth.Barr@menzies.edu.au..
Menzies School of Health Research, Darwin, Australia; Division of Medicine, Royal Darwin Hospital, Australia..
Menzies School of Health Research, Darwin, Australia..
Menzies School of Health Research, Darwin, Australia; Division of Medicine, Royal Darwin Hospital, Australia..
Austin Health, Melbourne, Australia; University of Melbourne, Melbourne, Australia..
Menzies School of Health Research, Darwin, Australia; Austin Health, Melbourne, Australia; University of Melbourne, Melbourne, Australia..
Austin Health, Melbourne, Australia; University of Melbourne, Melbourne, Australia..
SydPath, St Vincent's Hospital, Sydney, Australia; University of New South Wales, Sydney, Australia..
Menzies School of Health Research, Darwin, Australia..
Northern Territory Renal Services, Darwin, Australia; Northern Territory Department of Health, Darwin, Australia..
Division of Medicine, Royal Darwin Hospital, Australia; Division of Nephrology, Royal Darwin Hospital, Australia..
South Australian Health and Medical Research Institute, Adelaide, Australia; University of South Australia, Adelaide, Australia..
University of Queensland, Brisbane, Australia..
University of South Australia, Adelaide, Australia..
Menzies School of Health Research, Darwin, Australia..
St Vincent's Hospital Melbourne, Melbourne, Australia..
Issue Date: Apr-2017
Citation: Clinical biochemistry 2017-04; 50(6): 301-308
Abstract: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation that combines creatinine and cystatin C is superior to equations that include either measure alone in estimating glomerular filtration rate (GFR). However, whether cystatin C can provide any additional benefits in estimating GFR for Indigenous Australians, a population at high risk of end-stage kidney disease (ESKD) is unknown. Using a cross-sectional analysis from the eGFR Study of 654 Indigenous Australians at high risk of ESKD, eGFR was calculated using the CKD-EPI equations for serum creatinine (eGFRcr), cystatin C (eGFRcysC) and combined creatinine and cystatin C (eGFRcysC+cr). Reference GFR (mGFR) was determined using a non-isotopic iohexol plasma disappearance technique over 4h. Performance of each equation to mGFR was assessed by calculating bias, % bias, precision and accuracy for the total population, and according to age, sex, kidney disease, diabetes, obesity and c-reactive protein. Data were available for 542 participants (38% men, mean [sd] age 45 [14] years). Bias was significantly greater for eGFRcysC (15.0mL/min/1.73m2; 95% CI 13.3-16.4, p<0.001) and eGFRcysC+cr (10.3; 8.8-11.5, p<0.001) compared to eGFRcr (5.4; 3.0-7.2). Accuracy was lower for eGFRcysC (80.3%; 76.7-83.5, p<0.001) but not for eGFRcysC+cr (91.9; 89.3-94.0, p=0.29) compared to eGFRcr (90.0; 87.2-92.4). Precision was comparable for all equations. The performance of eGFRcysC deteriorated across increasing levels of c-reactive protein. Cystatin C based eGFR equations may not perform well in populations with high levels of chronic inflammation. CKD-EPI eGFR based on serum creatinine remains the preferred equation in Indigenous Australians.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10381
DOI: 10.1016/j.clinbiochem.2016.11.024
Type: Comparative Study
Journal Article
Subjects: CKD-EPI equation
Creatinine
Cystatin C
GFR
Indigenous
Adolescent
Adult
Algorithms
Australia
C-Reactive Protein
Creatinine
Cross-Sectional Studies
Cystatin C
Female
Humans
Kidney Function Tests
Male
Middle Aged
Population Groups
Renal Insufficiency, Chronic
Young Adult
Glomerular Filtration Rate
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