Comparison of creatinine and cystatin formulae with <sup>51</sup>Chromium‐ethylenediaminetetraacetic acid glomerular filtration rate in patients with decompensated cirrhosis

Ioannidou, Maria; Goulis, Ioannis; Chalevas, Parthenis; Ntogramatzi, Fani; Athanasiadou, Zoi; Νοτόπουλος, Αθανάσιος; Alevroudis, Manolis; Sinakos, Emmanouil; Akriviadis, Evangelos

doi:10.1111/jgh.13446

Cited by 20 publications

(25 citation statements)

References 23 publications

(53 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Its performance, when compared with creatinine-based estimates, has been better and more accurate in different populations. Although the cystatin C-based formulas have shown a superior performance and accuracy than the SCr-based formulas in the LC population, their performance has been poor in subjects with kidney function < 45 ml/min/1.73 m 2.3-5 Other groups have evaluated formulas that use both biomarkers (SCr and cystatin C), finding their results to be better than those of the formulas based only on creatinine or on cystatin C. However, performance in subjects with LC and a measurement of GFR (mGFR) < 60 ml/min was poor, agreeing with previously reported results 6,7 .…”

Section: Introductionsupporting

confidence: 78%

Evaluation of the Royal Free Hospital Cirrhosis Glomerular Filtration Rate Formula in Hispanic Patients with Cirrhosis: An External Validation

Tejeda-Maldonado

Niño-Cruz

Cruz-Rivera

et al. 2019

RIC

View full text Add to dashboard Cite

Background and Aims: Glomerular filtration rate (GFR) measurement in patients with liver cirrhosis (LC) is the ideal method for adequate evaluation of kidney function. However, it is invasive, costly, and not widely accessible. Moreover, GFR estimation in patients with cirrhosis has been inaccurate. The aim of the present study was to evaluate and validate the recently described Royal Free Hospital (RFH) formula in a Hispanic cohort of patients with LC and compare it with other formulas, including the CKD-EPI cystatin C equation. Methods: GFR was measured through the renal clearance of Tc-99m DTPA; it was cross-sectionally evaluated and compared with GFRs that were estimated utilizing the following formulas: RFH, Cockcroft-Gault, 6-variable Modification of Diet in Renal Disease-6, CKD-EPI cystatin C, CKD-EPI Creatinine, and CKD-EPI Cystatin C-Creatinine. Results: We included 76 patients (53% women). The mean measured GFR in the entire cohort was 64 ml/min/1.73m 2 ; 54% of the patients had a GFR < 60 ml/min/1.73 m 2 at the time of evaluation. The RFH formula and the CKD-EPI cystatin C formula showed the best performance, with a p30 of 62% and 59%, respectively. All formulas performed poorly when GFR was < 60 ml/min/1.73 m 2. Conclusions: The RFH formula showed a better performance than the other formulas based on serum creatinine in a Hispanic population with LC. There was no difference in performance between the RFH formula and the CKD-EPI cystatin C formula.

show abstract

Section: Introductionsupporting

confidence: 78%

Evaluation of the Royal Free Hospital Cirrhosis Glomerular Filtration Rate Formula in Hispanic Patients with Cirrhosis: An External Validation

Tejeda-Maldonado

Niño-Cruz

Cruz-Rivera

et al. 2019

RIC

View full text Add to dashboard Cite

show abstract

“…With the recent change in the definition of CKD in cirrhosis from the persistent elevation of serum creatinine (SCr) to >1.5 mg/dL to one that requires the glomerular filtration rate (GFR) to be <60 mL/minute/1.73 m 2 for more than 3 months, CKD now encompasses both organic CKD due to structural renal damage as well as functional CKD that is brought on by the gradual deterioration of hemodynamics as the liver dysfunction worsens, ie, so‐called hepatorenal syndrome type 2 (HRS2) . This has led to an apparent increase in the prevalence of CKD, ranging between 22% and 32%, especially when one considers both inpatients and outpatients with cirrhosis . This may be related to the recent increase in the prevalence of nonalcoholic fatty liver disease (NAFLD) worldwide and the associated type 2 diabetes and cardiovascular disease, which can lead to structural damage to the kidneys, such as diabetic nephropathy .…”

mentioning

confidence: 99%

“…(7) This has led to an apparent increase in the prevalence of CKD, ranging between 22% and 32%, especially when one considers both inpatients and outpatients with cirrhosis. (8)(9)(10)(11) This may be related to the recent increase in the prevalence of nonalcoholic fatty liver disease (NAFLD) worldwide and the associated type 2 diabetes and cardiovascular disease, which can lead to structural damage to the kidneys, such as diabetic nephropathy. (12) Better recognition of HRS2 may also be a factor leading to more patients with cirrhosis being identified as having CKD.…”

mentioning

confidence: 99%

Impact of Chronic Kidney Disease on Outcomes in Cirrhosis

Wong

Reddy

O’Leary³

et al. 2019

Liver Transpl

View full text Add to dashboard Cite

We hypothesize that the prevalence of chronic kidney disease (CKD) among patients with cirrhosis has increased due to the increased prevalence of CKD‐associated comorbidities, such as diabetes. We aimed to assess the characteristics of hospitalized patients with cirrhosis with CKD and its impact on renal and patient outcomes. The North American Consortium for the Study of End‐Stage Liver Disease (NACSELD) prospectively enrolled nonelectively admitted patients with cirrhosis and collected data on demographics, laboratory results, in‐hospital clinical course, and postdischarge 3‐month outcomes. CKD positive (CKD+) patients, defined as having an estimated glomerular filtration rate (eGFR; Modification of Diet in Renal Disease–4 variable formula) of ≤60 mL/minute for >3 months, were compared with chronic kidney disease negative (CKD–) patients for development of organ failures, hospital course, and survival. There were 1099 CKD+ patients (46.8% of 2346 enrolled patients) who had significantly higher serum creatinine (2.21 ± 1.33 versus 0.83 ± 0.21 mg/dL in the CKD– group) on admission, higher prevalence of nonalcoholic steatohepatitis cirrhosis etiology, diabetes, refractory ascites, and hospital admissions in the previous 6 months compared with the CKD– group (all P < 0.001). Propensity matching (n = 922 in each group) by Child‐Pugh scores (9.78 ± 2.05 versus 9.74 ± 2.04, P = 0.70) showed that CKD+ patients had significantly higher rates of superimposed acute kidney injury (AKI; 68% versus 21%; P < 0.001) and eventual need for dialysis (11% versus 2%; P < 0.001) than CKD– patients. CKD+ patients also had more cases of acute‐on‐chronic liver failure as defined by the NACSELD group, which was associated with reduced 30‐ and 90‐day overall survival (P < 0.001 for both). A 10 mL/minute drop in eGFR was associated with a 13.1% increase in the risk of 30‐day mortality. In conclusion, patients with CKD should be treated as a high‐risk group among hospitalized patients with cirrhosis due to their poor survival, and they should be monitored carefully for the development of superimposed AKI.

show abstract

“…Chronic liver disease is associated with inaccuracy of the eGFR formulas[ 103 - 105 ]. Creatinine-based eGFR formulas systematically overestimate measured GFR in this patient group and the degree of overestimation increases with the severity of liver disease[ 104 ].…”

Section: Limitations Of the Formulas Computing Egfrmentioning

confidence: 99%

Establishing the presence or absence of chronic kidney disease: Uses and limitations of formulas estimating the glomerular filtration rate

Alaini

Malhotra

Rondon‐Berrios

et al. 2017

WJM

View full text Add to dashboard Cite

The development of formulas estimating glomerular filtration rate (eGFR) from serum creatinine and cystatin C and accounting for certain variables affecting the production rate of these biomarkers, including ethnicity, gender and age, has led to the current scheme of diagnosing and staging chronic kidney disease (CKD), which is based on eGFR values and albuminuria. This scheme has been applied extensively in various populations and has led to the current estimates of prevalence of CKD. In addition, this scheme is applied in clinical studies evaluating the risks of CKD and the efficacy of various interventions directed towards improving its course. Disagreements between creatinine-based and cystatin-based eGFR values and between eGFR values and measured GFR have been reported in various cohorts. These disagreements are the consequence of variations in the rate of production and in factors, other than GFR, affecting the rate of removal of creatinine and cystatin C. The disagreements create limitations for all eGFR formulas developed so far. The main limitations are low sensitivity in detecting early CKD in several subjects, e.g., those with hyperfiltration, and poor prediction of the course of CKD. Research efforts in CKD are currently directed towards identification of biomarkers that are better indices of GFR than the current biomarkers and, particularly, biomarkers of early renal tissue injury.

show abstract

Comparison of creatinine and cystatin formulae with ⁵¹Chromium‐ethylenediaminetetraacetic acid glomerular filtration rate in patients with decompensated cirrhosis

Abstract: The specific mathematical formulae derived from patients with cirrhosis seem to provide superior assessment of renal function, compared with the conventional used sCr-based and cysC-based formulae.

Cited by 20 publications

References 23 publications

Evaluation of the Royal Free Hospital Cirrhosis Glomerular Filtration Rate Formula in Hispanic Patients with Cirrhosis: An External Validation

Evaluation of the Royal Free Hospital Cirrhosis Glomerular Filtration Rate Formula in Hispanic Patients with Cirrhosis: An External Validation

Impact of Chronic Kidney Disease on Outcomes in Cirrhosis

Establishing the presence or absence of chronic kidney disease: Uses and limitations of formulas estimating the glomerular filtration rate

Contact Info

Product

Resources

About

Comparison of creatinine and cystatin formulae with 51Chromium‐ethylenediaminetetraacetic acid glomerular filtration rate in patients with decompensated cirrhosis

Abstract: The specific mathematical formulae derived from patients with cirrhosis seem to provide superior assessment of renal function, compared with the conventional used sCr-based and cysC-based formulae.

Cited by 20 publications

References 23 publications

Evaluation of the Royal Free Hospital Cirrhosis Glomerular Filtration Rate Formula in Hispanic Patients with Cirrhosis: An External Validation

Evaluation of the Royal Free Hospital Cirrhosis Glomerular Filtration Rate Formula in Hispanic Patients with Cirrhosis: An External Validation

Impact of Chronic Kidney Disease on Outcomes in Cirrhosis

Establishing the presence or absence of chronic kidney disease: Uses and limitations of formulas estimating the glomerular filtration rate

Contact Info

Product

Resources

About

Comparison of creatinine and cystatin formulae with ⁵¹Chromium‐ethylenediaminetetraacetic acid glomerular filtration rate in patients with decompensated cirrhosis