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Comparison of the diagnostic accuracy of CKD-EPI cystatin-C, CKD-EPI creatinine and 24-hour creatinine clearance for estimating GFR: a preliminary study

Year 2021, Volume: 46 Issue: 1, 1 - 10, 31.03.2021

Abstract

Purpose: Serum cystatin C level is a specific marker to estimate the glomerular filtration rate (GFR). Due to this specificity, we assume that GFR estimations based on cystatin C have higher diagnostic performances than GFR estimations using other biomarkers. In this study, we aimed to compared the diagnostic performances of CKD-EPI cystatin C equation, CKD-EPI creatinine equation and 24-hour creatinine clearance to estimate GFR.
Materials and Methods: A total of 130 participants who consisting of 101 acute and chronic renal disease patients and 29 healthy volunteers, who applied to the Nephrology Clinic, have been included in our study. Their urine creatinine levels and serum creatinine levels were measured by the colorimetric-Jaffe method, and cystatin C was by the nephelometric method.
Results: There was a statistically significant relationship between CKD-EPI cystatin C, between CKD-EPI creatinine and standard creatinine clearance. The Area Under the Receiver Operating Characteristics curve (AUROC) was found to be 1, 0.995, and 0.954 respectively.
Conclusion: According to the results, we think that serum cystatin C levels will present earlier findings in GFR decrease and may be a more effective marker than serum creatinine and standard creatinine clearance in the early period.

Thanks

We would like to thank dear Metin UÇUCU and Talha KARABIYIK for their support in the preparation of this article.

References

  • 1. Li, P.K.-T., et al., Kidney health for everyone everywhere: from prevention to detection and equitable access to care. 2020, Oxford University Press US.
  • 2. Bakanlığı, T.S., Türkiye böbrek hastalıkları önleme ve kontrol programı 2014-2017. Erişim Tarihi, 2019. 10.
  • 3. Sezer, S., et al., The effect of serum creatinine measured with different assays on formula based estimated glomerular filtration rate. TURKISH JOURNAL OF BIOCHEMISTRY-TURK BIYOKIMYA DERGISI, 2012. 37(4): p. 471-477.
  • 4. Group, K.D.I.G.O.C.W., KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl, 2013. 3(1): p. 1-150.
  • 5. Levey, A.S., et al., K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. American Journal of Kidney Diseases, 2002. 39(2 SUPPL. 1).
  • 6. Akoğlu, H., Altun, B., Screenıng Tests In Kıdney DıseasesHacettepe Üniversitesi Tıp Fakültesi, Ankara Turkiye Klinikleri J Int Med Sci. 2007;3(38): p. 8-18.
  • 7. Levey, A.S., et al., A new equation to estimate glomerular filtration rate. Annals of internal medicine, 2009. 150(9): p. 604-612.
  • 8. Levey, A.S., C. Becker, and L.A. Inker, Glomerular filtration rate and albuminuria for detection and staging of acute and chronic kidney disease in adults: a systematic review. Jama, 2015. 313(8): p. 837-846.
  • 9. Odutayo, A. and D. Cherney, Cystatin C and acute changes in glomerular filtration rate. Clinical nephrology, 2012. 78(1): p. 64-75.
  • 10. Sjöström, P., M. Tidman, and I. Jones, The shorter T1/2 of cystatin C explains the earlier change of its serum level compared to serum creatinine. Clinical nephrology, 2004. 62(3): p. 241.
  • 11. Coll, E., et al., Serum cystatin C as a new marker for noninvasive estimation of glomerular filtration rate and as a marker for early renal impairment. American journal of kidney diseases, 2000. 36(1): p. 29-34.
  • 12. Yong, Z., et al., Predictive value of serum cystatin C for acute kidney injury in adults: a meta-analysis of prospective cohort trials. Scientific reports, 2017. 7(1): p. 1-11.
  • 13. Jacobs, A., et al., Clinical relevance of differences in glomerular filtration rate estimations in frail older people by creatinine-vs. cystatin C-based formulae. Drugs & aging, 2017. 34(6): p. 445-452.
  • 14. Kwon, Y.E., et al., Cystatin C is better than serum creatinine for estimating glomerular filtration rate to detect osteopenia in chronic kidney disease patients. Yonsei medical journal, 2017. 58(2): p. 380-387.
  • 15. Yang, S.k., et al., Diagnostic Accuracy of Serum Cystatin C for the Evaluation of Renal Dysfunction in Diabetic Patients: A Meta‐Analysis. Therapeutic Apheresis and Dialysis, 2016. 20(6): p. 579-587.
  • 16. Bevc, S., et al., Simple cystatin C formula compared to sophisticated CKD‐EPI formulas for estimation of glomerular filtration rate in the elderly. Therapeutic Apheresis and Dialysis, 2011. 15(3): p. 261-268.
  • 17. Royakkers, A.A., et al., Serum and urine cystatin C are poor biomarkers for acute kidney injury and renal replacement therapy. Intensive care medicine, 2011. 37(3): p. 493-501.
  • 18. Laterza, O.F., C.P. Price, and M.G. Scott, Cystatin C: an improved estimator of glomerular filtration rate? Clinical chemistry, 2002. 48(5): p. 699-707.
  • 19. Arınsoy,T., Güngör, Ö., Koçyiğit, İ., BöbrekFizyopatolojisiRes2017.3: p. 208-26.
  • 20. Eriksen, B.O., et al., Cystatin C is not a better estimator of GFR than plasma creatinine in the general population. Kidney international, 2010. 78(12): p. 1305-1311.
  • 21. Knight, E.L., et al., Factors influencing serum cystatin C levels other than renal function and the impact on renal function measurement. Kidney international, 2004. 65(4): p. 1416-1421.
  • 22. Rule, A.D., et al., Glomerular filtration rate estimated by cystatin C among different clinical presentations. Kidney international, 2006. 69(2): p. 399-405.
  • 23. Grubb, A.O., Cystatin C-properties and use as diagnostic marker. Advances in clinical chemistry, 2001. 35: p. 63-99.
  • 24. Manetti, L., et al., Thyroid function differently affects serum cystatin Cand creatinine concentrations. Journal of endocrinological investigation, 2005. 28(6): p. 346-349.
  • 25. Shlipak, M.G., et al., Cystatin C and the risk of death and cardiovascular events among elderly persons. New England Journal of Medicine, 2005. 352(20): p. 2049-2060.

GFR tahmininde CKD-EPI sistatin-C, CKD-EPI kreatinin ve 24 saatlik kreatinin klirensinin tanısal doğruluğunun karşılaştırılması: bir ön çalışma

Year 2021, Volume: 46 Issue: 1, 1 - 10, 31.03.2021

Abstract

Amaç: Serum sistatin C düzeyi, glomerüler filtrasyon hızını (GFH) tahmin etmek için spesifik bir belirteçtir. Bu özgüllük nedeniyle, sistatin C'ye dayalı GFH tahminlerinin, diğer biyobelirteçleri kullanan GFH tahminlerinden daha yüksek tanısal performanslara sahip olduğunu varsayıyoruz. Bu çalışmada, GFH'yi tahmin etmek için CKD-EPI sistatin C denklemi, CKD-EPI kreatinin denklemi ve 24 saatlik kreatinin klirensinin tanısal performanslarını karşılaştırmayı amaçladık.
Gereç ve Yöntem: Çalışmamıza Nefroloji Kliniğine başvuran akut ve kronik böbrek hastalarından oluşan 101 hasta ve 29 sağlıklı gönüllüden oluşan toplam 130 katılımcıdâhil edildi. İdrar kreatinin düzeyleri ve serum kreatinin düzeyleri kolorimetrik-Jaffe yöntemi ile ölçülürken, sistatin C nefelometrik yöntemle ölçüldü.
Bulgular: CKD-EPI sistatin C, CKD-EPI kreatinin ve standart kreatinin klirensi arasında istatistiksel olarak anlamlı bir ilişki vardı. Alıcı Çalışma Karakteristikleri eğrisinin (AUROC) Altındaki Alan sırasıyla 1, 0.995 ve 0.954 olarak bulundu.
Sonuç: Elde edilen sonuçlara göre, serum sistatin C düzeylerinin GFH azalmasında daha erken bulgular sunacağı ve erken dönemde serum kreatinin ve standart kreatinin klirensinden daha etkili bir belirteç olabileceği kanısındayız.

References

  • 1. Li, P.K.-T., et al., Kidney health for everyone everywhere: from prevention to detection and equitable access to care. 2020, Oxford University Press US.
  • 2. Bakanlığı, T.S., Türkiye böbrek hastalıkları önleme ve kontrol programı 2014-2017. Erişim Tarihi, 2019. 10.
  • 3. Sezer, S., et al., The effect of serum creatinine measured with different assays on formula based estimated glomerular filtration rate. TURKISH JOURNAL OF BIOCHEMISTRY-TURK BIYOKIMYA DERGISI, 2012. 37(4): p. 471-477.
  • 4. Group, K.D.I.G.O.C.W., KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl, 2013. 3(1): p. 1-150.
  • 5. Levey, A.S., et al., K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. American Journal of Kidney Diseases, 2002. 39(2 SUPPL. 1).
  • 6. Akoğlu, H., Altun, B., Screenıng Tests In Kıdney DıseasesHacettepe Üniversitesi Tıp Fakültesi, Ankara Turkiye Klinikleri J Int Med Sci. 2007;3(38): p. 8-18.
  • 7. Levey, A.S., et al., A new equation to estimate glomerular filtration rate. Annals of internal medicine, 2009. 150(9): p. 604-612.
  • 8. Levey, A.S., C. Becker, and L.A. Inker, Glomerular filtration rate and albuminuria for detection and staging of acute and chronic kidney disease in adults: a systematic review. Jama, 2015. 313(8): p. 837-846.
  • 9. Odutayo, A. and D. Cherney, Cystatin C and acute changes in glomerular filtration rate. Clinical nephrology, 2012. 78(1): p. 64-75.
  • 10. Sjöström, P., M. Tidman, and I. Jones, The shorter T1/2 of cystatin C explains the earlier change of its serum level compared to serum creatinine. Clinical nephrology, 2004. 62(3): p. 241.
  • 11. Coll, E., et al., Serum cystatin C as a new marker for noninvasive estimation of glomerular filtration rate and as a marker for early renal impairment. American journal of kidney diseases, 2000. 36(1): p. 29-34.
  • 12. Yong, Z., et al., Predictive value of serum cystatin C for acute kidney injury in adults: a meta-analysis of prospective cohort trials. Scientific reports, 2017. 7(1): p. 1-11.
  • 13. Jacobs, A., et al., Clinical relevance of differences in glomerular filtration rate estimations in frail older people by creatinine-vs. cystatin C-based formulae. Drugs & aging, 2017. 34(6): p. 445-452.
  • 14. Kwon, Y.E., et al., Cystatin C is better than serum creatinine for estimating glomerular filtration rate to detect osteopenia in chronic kidney disease patients. Yonsei medical journal, 2017. 58(2): p. 380-387.
  • 15. Yang, S.k., et al., Diagnostic Accuracy of Serum Cystatin C for the Evaluation of Renal Dysfunction in Diabetic Patients: A Meta‐Analysis. Therapeutic Apheresis and Dialysis, 2016. 20(6): p. 579-587.
  • 16. Bevc, S., et al., Simple cystatin C formula compared to sophisticated CKD‐EPI formulas for estimation of glomerular filtration rate in the elderly. Therapeutic Apheresis and Dialysis, 2011. 15(3): p. 261-268.
  • 17. Royakkers, A.A., et al., Serum and urine cystatin C are poor biomarkers for acute kidney injury and renal replacement therapy. Intensive care medicine, 2011. 37(3): p. 493-501.
  • 18. Laterza, O.F., C.P. Price, and M.G. Scott, Cystatin C: an improved estimator of glomerular filtration rate? Clinical chemistry, 2002. 48(5): p. 699-707.
  • 19. Arınsoy,T., Güngör, Ö., Koçyiğit, İ., BöbrekFizyopatolojisiRes2017.3: p. 208-26.
  • 20. Eriksen, B.O., et al., Cystatin C is not a better estimator of GFR than plasma creatinine in the general population. Kidney international, 2010. 78(12): p. 1305-1311.
  • 21. Knight, E.L., et al., Factors influencing serum cystatin C levels other than renal function and the impact on renal function measurement. Kidney international, 2004. 65(4): p. 1416-1421.
  • 22. Rule, A.D., et al., Glomerular filtration rate estimated by cystatin C among different clinical presentations. Kidney international, 2006. 69(2): p. 399-405.
  • 23. Grubb, A.O., Cystatin C-properties and use as diagnostic marker. Advances in clinical chemistry, 2001. 35: p. 63-99.
  • 24. Manetti, L., et al., Thyroid function differently affects serum cystatin Cand creatinine concentrations. Journal of endocrinological investigation, 2005. 28(6): p. 346-349.
  • 25. Shlipak, M.G., et al., Cystatin C and the risk of death and cardiovascular events among elderly persons. New England Journal of Medicine, 2005. 352(20): p. 2049-2060.
There are 25 citations in total.

Details

Primary Language English
Subjects Biochemistry and Cell Biology (Other)
Journal Section Research
Authors

Süheyl Uçucu 0000-0002-6320-2457

Durmuş Ayan

Publication Date March 31, 2021
Acceptance Date September 29, 2020
Published in Issue Year 2021 Volume: 46 Issue: 1

Cite

MLA Uçucu, Süheyl and Durmuş Ayan. “Comparison of the Diagnostic Accuracy of CKD-EPI Cystatin-C, CKD-EPI Creatinine and 24-Hour Creatinine Clearance for Estimating GFR: a Preliminary Study”. Cukurova Medical Journal, vol. 46, no. 1, 2021, pp. 1-10.