Body mass does not have a clinically relevant effect on cystatin C eGFR in children

Sharma, Ajay; Kathiravelu, Anusha; Nadarajah, Renisha; Yasin, Abeer; Filler, Guido

doi:10.1093/ndt/gfn505

Cited by 45 publications

(35 citation statements)

References 14 publications

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“…In children, age and body mass do not significantly affect cystatin C eGFR (13). The known confounders affecting cystatin C levels such as corticosteroids and thyroid status cannot explain the variability in the performance of different cystatin C equations either (3,8,11).…”

Section: Introductionmentioning

confidence: 88%

“…The known confounders affecting cystatin C levels such as corticosteroids and thyroid status cannot explain the variability in the performance of different cystatin C equations either (3,8,11). Previous studies have demonstrated that the variance between cystatin C eGFR and measured GFR increases in the high GFR range when compared with that in the low GFR range (3,13). The cystatin C eGFR estimates by different equations also show a higher interequation variability at a higher GFR (14).…”

Section: Introductionmentioning

confidence: 97%

“…Various cystatin C equations consistently demonstrate a variance between the measured GFR and cystatin C estimated GFR (eGFR) in the magnitude of 20% to 30% (2,3,13). With different equations, the estimates of cystatin C eGFR also vary for the same cystatin C level (3,11,14).…”

Section: Introductionmentioning

confidence: 99%

“…The use of different gold standards for measuring GFR cannot completely account for the difference in the estimated and measured GFR (2,3,13). In children, age and body mass do not significantly affect cystatin C eGFR (13).…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic Accuracy of Cystatin C–Based eGFR Equations at Different GFR Levels in Children

Sharma

Yasin

Garg

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives The diagnostic accuracy of cystatin C estimated GFR (eGFR) by various cystatin C equations have varied in different studies. We hypothesized that the GFR level of enrolled patients affects the diagnostic accuracy of a cystatin C equation.Design, setting, participants, & measurements We analyzed 240 consecutively enrolled children at a single Canadian center in a prospective and cross-sectional study. Cystatin C was analyzed with nephelometry, and cystatin C eGFR was estimated by the equations validated in children. GFR was measured by technetium-99m-diethylene-triamine penta-acetic acid ( 99m Tc DTPA).Results We compared various cystatin C equations across GFR strata Ͻ60, Ͻ90, Ն135, and Ն150 ml/min per 1.73 m 2 for an accurate prediction and appropriate classification of the measured GFR. The CKiD, Zappitelli-CysEq, and Zappitelli-CysCrEq equations had a higher accuracy, estimated by eGFR values within 10% and 30% of the respective 99m Tc DTPA, in the GFR categories Ͻ60 and Ͻ90 ml/min per 1.73 m 2 , whereas the Bö kenkamp, Bouvet, and Filler equations had a greater accuracy in the GFR categories Ն135 and Ն150 ml/min per 1.73 m 2 . The Bouvet, CKiD, Filler, Zappitelli-CysEq, and Zappitelli-CysCrEq equations had a greater sensitivity to classify GFR Ͻ60 and Ͻ90 ml/min per 1.73 m 2 , whereas the Bö kenkamp equation had a higher sensitivity for GFR Ն135 and Ն150 ml/min per 1.73 m 2 . ConclusionsThe diagnostic accuracy of various cystatin C equations varies with GFR. This issue needs consideration while applying these equations in clinical practice and for further research on eGFR equations.

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Section: Introductionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnostic Accuracy of Cystatin C–Based eGFR Equations at Different GFR Levels in Children

Sharma

Yasin

Garg

et al. 2011

Clinical Journal of the American Society of Nephrology

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“…However, serum creatinine is largely affected by maternal GFR as creatinine crosses the placenta [8]. Over the last decade, cystatin C, a low molecular weight cysteine protease that is constantly produced by all nucleated cells [9], has evolved as a promising alternative to serum creatinine, with a better diagnostic sensitivity [10] and independence of muscle mass [11] and body composition [12]. Currently, the best estimated (e)GFR formulae in children can be derived from cystatin C alone or in combination with creatinine and/or urea [13].…”

Section: Introductionmentioning

confidence: 99%

Cystatin C adaptation in the first month of life

Filler

Lepage

2013

Pediatr Nephrol

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Je-Hyan Lee et al. have published a study on cystatin C concentrations in the first 30 days of life in 127 pre-term and 119 term neonates in this edition of Pediatric Nephrology, thereby closing a knowledge gap of detailed cystatin C concentrations beyond 72 h of life by day of life and by post-conceptional age. While the study objective has merit and a large number of measurements were included, there are some methodological limitations that bring the validity of the data into question as pure reference intervals for children up to 1 month of age, mostly because of the inclusion of patients that potentially could have an impaired glomerular filtration rate (GFR), for instance due to exposure to nephrotoxic drugs. We discuss the strengths and weaknesses of the study and outline an approach to definitely close this knowledge gap. We call for a worldwide collaboration to use Box-Cox transformations similar to the methodology used with growth charts to calculate ageindependent z-scores and percentiles of neonatal and infant markers of GFR. This could also lead to better definitions of acute kidney injury in infants if GFR markers cross the percentiles based on post-conceptional or chronological age.

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Assessment of Kidney Function in Children, Adolescents, and Young Adults

Filler

Ferris

Gattineni

2022

Pediatric Nephrology

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Body mass does not have a clinically relevant effect on cystatin C eGFR in children

Abstract: In children, body mass exerts a minimal effect on the performance of CysC eGFR estimation.

Cited by 45 publications

References 14 publications

Diagnostic Accuracy of Cystatin C–Based eGFR Equations at Different GFR Levels in Children

Diagnostic Accuracy of Cystatin C–Based eGFR Equations at Different GFR Levels in Children

Cystatin C adaptation in the first month of life

Assessment of Kidney Function in Children, Adolescents, and Young Adults

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