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- Title
CKD-EPI creatinine-cystatin C glomerular filtration rate estimation equation seems more suitable for Chinese patients with chronic kidney disease than other equations.
- Authors
Xiao-Hua Chi; Gui-Ping Li; Quan-Shi Wang; Yong-Shuai Qi; Kai Huang; Qian Zhang; Yao-ming Xue; Chi, Xiao-Hua; Li, Gui-Ping; Wang, Quan-Shi; Qi, Yong-Shuai; Huang, Kai; Zhang, Qian; Xue, Yao-Ming
- Abstract
<bold>Background: </bold>The 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.<bold>Methods: </bold>A 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.<bold>Results: </bold>By 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).<bold>Conclusion: </bold>For 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.
- Subjects
CREATININE; CYSTATINS; GLOMERULAR filtration rate; CHRONIC kidney failure; NEPHROLOGY; ASIANS; PROTEINS; RETROSPECTIVE studies
- Publication
BMC Nephrology, 2017, Vol 18, p1
- ISSN
1471-2369
- Publication type
journal article
- DOI
10.1186/s12882-017-0637-z