A comparison between cystatin C, plasma creatinine and the Cockcroft and Gault formula for the estimation of glomerular filtration rate

Abstract

Cys C shows a high correlation with GFR. With a very simple formula, cys C gives a good estimate of GFR, more accurate and precise than C&G. Because biological variation is low, cys C gives also a good assessment of GFR changes during follow-up. Cys C is the preferred endogenous parameter for GFR.

Monitoring renal function: measured and estimated glomerular filtration rates - a review

“…Serum CysC concentration increases already with mildly reduced GFR of 70 to 90 mL/min, i.e., in the "creatinine-blind range" (45). In addition, recent longitudinal studies have reported that CysC concentrations increase earlier in acute kidney injury in the intensive care unit, in cardiac surgery, coronary angiography, after liver transplantation, cisplatin chemotherapy, following uninephrectomy, and in progressive diabetic nephropathy (46).…”

“…In contrast to the MDRD equation, which was calculated from a large population in a multicenter study, CysC-based equations were created and validated in smaller samples using different gold standard measurements for GFR. Table 3 highlights some CysCbased equations for adults (29,45,(51)(52)(53)(54)(55)(56).…”

“…The vast majority, when comparing bias, precision, accuracy, and correlation, found CysC-based equations to be superior to creatinine-based equations as estimates of GFR (45,52,53), while some reported no difference in the performance of CysC-and creatinine-based equations (29,54). Recently, in order to improve the estimated kidney function, estimated GFR equations were developed, which incorporate both SCr and CysC.…”

Estimating glomerular filtration rate in diabetes: a comparison of cystatin-C- and creatinine-based methods

“…It has recently been shown that GFR derived from a simple regression equation based on the relationship between the reciprocal of serum cystatin C levels and GFR measured by 125 I iothalamate clearance was a more accurate estimate of renal function than the Cockcroft-Gault (C-G) formulas in subjects with and without diabetes [2]. However, the bias, precision (standard deviation of the difference from a reference method) and accuracy (within 15, 30 and 50% of reference method values) for a GFR estimated from serum cystatin C levels have not been compared with the abbreviated Modification of Diet in Renal Disease 4 variable formula (MDRD-4) or C-G formula in patients with diabetes and a wide range of renal function.…”

Controle da hiperfosfatemia na DRC

“…[1][2][3][4][5][6]18 It is freely filtered by the glomeruli (due to its low molecular weight combined to positive electric charge), 4,5,19 and, according to initial studies, its serum concentration does not depend on age, sex, muscle mass and body weight. 5,[16][17][18][19][20] No relevant difference between reference values for males and females has been reported. For healthy children, cystatin C concentration is stable in the second year of life, and the reference value is identical to that of adults.…”