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Int J Nephrol. 2014;2014:837106. doi: 10.1155/2014/837106. Epub 2014 Aug 24.

Estimation of Glomerular Filtration Rate Based on Serum Cystatin C versus Creatinine in a Uruguayan Population.

Author information

1
Unidad de Hipertensión Arterial, Hospital de Clínicas Dr. Manuel Quintela, Universidad de la República, Avenida Italia 2870, 11600 Montevideo, Uruguay ; Departamento de Fisiopatología, Universidad de la República, Montevideo, Uruguay.
2
Unidad de Hipertensión Arterial, Hospital de Clínicas Dr. Manuel Quintela, Universidad de la República, Avenida Italia 2870, 11600 Montevideo, Uruguay ; Departamento de Fisiopatología, Universidad de la República, Montevideo, Uruguay ; Centro de Nefrología, Universidad de la República, Montevideo, Uruguay.
3
Departamento Laboratorio de Patología Clínica at Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay.
4
Department of Cardiovascular Sciences, Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, University of Leuven (KU Leuven), Leuven, Belgium.
5
Unidad de Hipertensión Arterial, Hospital de Clínicas Dr. Manuel Quintela, Universidad de la República, Avenida Italia 2870, 11600 Montevideo, Uruguay.
6
Departamento de Métodos Cuantitativos, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
7
Departamento de Fisiopatología, Universidad de la República, Montevideo, Uruguay ; Centro de Nefrología, Universidad de la República, Montevideo, Uruguay.
8
Unidad de Hipertensión Arterial, Hospital de Clínicas Dr. Manuel Quintela, Universidad de la República, Avenida Italia 2870, 11600 Montevideo, Uruguay ; Centro de Nefrología, Universidad de la República, Montevideo, Uruguay.
9
Department of Cardiovascular Sciences, Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, University of Leuven (KU Leuven), Leuven, Belgium ; Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.

Abstract

BACKGROUND:

Estimation of glomerular filtration rate (eGFR) from biomarkers has evolved and multiple equations are available to estimate renal function at bedside.

METHODS:

In a random sample of 119 Uruguayans (54.5% women; 56.2 years (mean)), we used Bland and Altman's method and Cohen's kappa statistic to assess concordance on a continuous or categorical (eGFR < 60 versus ≥60 mL/min/1.73 m(2)) scale between eGFRcys (reference) and eGFR derived from serum creatinine according to the Modification of Diet in Renal Disease (eGFRmdrd) or the Chronic Kidney Disease Epidemiology Collaboration equations (eGFRepi) or from both serum cystatin C and creatinine (eGFRmix).

RESULTS:

In all participants, eGFRmdrd, eGFRepi, and eGFRmix were, respectively, 9.7, 11.5, and 5.6 mL/min/1.73 m(2) higher (P < 0.0001) than eGFRcys. The prevalence of eGFR <60 mL/min/1.73 m(2) was the highest for eGFRcys (21.8%), intermediate for eGFRmix (11.8%), and the lowest for eGFRmdrd (5.9%) and eGFRepi (3.4%). Using eGFRcys as reference, we found only fair agreement with the equations based on creatinine (Cohen's kappa statistic 0.15 to 0.23).

CONCLUSION:

Using different equations we reached clinically significant differences in the estimation of renal function. eGFRcys provides lower estimates, resulting in higher prevalence of eGFR <60 mL/min/1.73 m(2).

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