Estimating GFR Using Serum Cystatin C Alone and in Combination With Serum Creatinine: A Pooled Analysis of 3,418 Individuals With CKD

Abstract

Serum cystatin C level alone provides GFR estimates that are nearly as accurate as serum creatinine level adjusted for age, sex, and race, thus providing an alternative GFR estimate that is not linked to muscle mass. An equation including serum cystatin C level in combination with serum creatinine level, age, sex, and race provides the most accurate estimates.

Measured GFR as a Confirmatory Test for Estimated GFR

“…3 New equations based on creatinine, as well as novel filtration markers, such as cystatin C, will likely improve the accuracy in some populations, but the likelihood of error will remain. 4,5 Recognition of the strengths and limitations of any estimating equation, and the clinical settings when GFR estimates are likely to be inaccurate, will enable identification of those patients in whom a measured GFR should be considered.…”

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

“…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).…”

“…These equations, including serum CysC in combination with SCr, age, gender and race, performed better compared to the creatinineand CysC-based equations regarding to bias, precision and accuracy (57)(58)(59). In this setting, Stevens et al (56) developed new equations to estimate GFR using serum CysC alone or serum CysC and SCr in combination with demographic variables. The individuals were screened for 3 CKD studies in the United States (N = 2980) and a clinical population was studied in Paris, France (N = 438).…”

Estimation of renal function in patients with chronic kidney disease

“…The most simple cystatin-based equation for estimated GFR from the refitted dataset was: eGFR ¼ 76.7*CystatineC À1. 19 , although slightly better results may be obtained by including age, sex, and race in the equation (38).…”