The relationship between serum creatinine, serum cystatin C and glomerular filtration rate in pediatric renal transplant recipients: A pilot study

Krieser, David; Rosenberg, Andrew R.; Kainer, Gad; Naidoo, Daya

doi:10.1034/j.1399-3046.2002.02012.x

Cited by 29 publications

(24 citation statements)

References 16 publications

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“…In addition, using prediction equations based on serum creatinine concentration can be problematic if creatinine concentrations are not at steady state (Payne, 1986;Perrone et al, 1992). Although the use of serum cystatin C as a parameter for predicting renal function has been recently suggested (Stabuc et al, 2000;Dharnidharka et al, 2002), its use in paediatric patients appears to offer few advantages over that of serum creatinine (Krieser et al, 2002;Willems et al, 2003). While cystatin C measurements were not obtained as a part of the current study, it seems unlikely that its use would have made a significant difference to the results obtained.…”

Section: Discussioncontrasting

confidence: 45%

Estimation of glomerular filtration rate in paediatric cancer patients using 51CR-EDTA population pharmacokinetics

et al. 2004

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Estimation of glomerular filtration rate (GFR) using the clearance of chromium 51 EDTA ( 51 Cr-EDTA) (or other radiolabelled isotopes) is reliable, but invasive and not always practicable. Mathematical models have been devised for estimating GFR using readily obtainable patient characteristics. Unfortunately, these models were developed using various patient populations and may not provide the optimal prediction of GFR in children with cancer. The current study uses population pharmacokinetics to determine the relationship between 51 Cr-EDTA clearance, and patient covariates in 50 paediatric cancer patients. These models were validated using a separate group of 43 children and were compared with previously published models of renal function. Body size was the major determinant of 51 Cr-EDTA clearance and inclusion of weight or surface area reduced the residual variability between individuals (coefficient of variation) from 61 to 32%. Serum creatinine was the only other parameter that significantly improved the model. Mean percentage error values of -5.0 and -1.1% were observed for models including weight alone or weight and creatinine, respectively, with precision estimates of 21.7 and 20.0%. These simple additive models provide a more rationale approach than the use of complex formulae, involving additional parameters, to predict renal function.

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Section: Discussioncontrasting

confidence: 45%

Estimation of glomerular filtration rate in paediatric cancer patients using 51CR-EDTA population pharmacokinetics

et al. 2004

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“…Results are contradictory, some being in favour of CysC (55,(85)(86)(87)(144)(145)(146), whereas others find that it has no added value (87-89, 104, 140). This may be explained by the inherent limitations of specifically studying children, discussed above, and also by the fact that many authors did not separate out children who were or were not receiving corticosteroid therapy (144,147,148). The use of different creatinine assay methods (Jaffé vs. enzymatic) and more or less appropriate correct use of the Schwartz equation (with or without a laboratory-specific correction factor) could also explain some discrepancies between the results (117,124).…”

Section: Paediatric Populationsmentioning

confidence: 99%

Cystatin C: current position and future prospects

Séronie-Vivien

Delanaye

Piéroni³

et al. 2008

Clinical Chemistry and Laboratory Medicine

162

145

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Cystatin C is a low-molecular-weight protein which has been proposed as a marker of renal function that could replace creatinine. Indeed, the concentration of cystatin C is mainly determined by glomerular filtration and is particularly of interest in clinical settings where the relationship between creatinine production and muscle mass impairs the clinical performance of creatinine. Since the last decade, numerous studies have evaluated its potential use in measuring renal function in various populations. More recently, other potential developments for its clinical use have emerged. This review summarises current knowledge about the physiology of cystatin C and about its use as a renal marker, either alone or in equations developed to estimate the glomerular filtration rate. This paper also reviews recent data about the other applications of cystatin C, particularly in cardiology, oncology and clinical pharmacology. Clin Chem Lab Med 2008;46:1664-86.

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“…CystC meets only a few criteria of an ideal renal function marker because it is produced at a constant rate and is freely filtered in the glomerulus without tubular secretion; however, it is catabolized in the tubulus (9). The reports about the value of CystC as a GFR marker, particularly in pediatric kidney transplantation, have been contradictory because of the influence of prednisone and calcineurin inhibitors on CystC concentration (10,11). Therefore, CystC-based or combined PCr-CystC GFR-predicting equations have been established in various populations, especially in pediatric patients (12)(13)(14)(15), but few equations have been specifically developed for transplant patients.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Different Equations in Estimating GFR in Pediatric Kidney Transplant Recipients

Souza¹,

Cochat²,

Rabilloud³

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objective The knowledge of renal function is crucial for the management of pediatric kidney transplant recipients. In this population, the most commonly used plasma creatinine (PCr)-based or cystatin C (CystC)-based GFR-predicting formulas may underperform (e.g., corticosteroids and trimethoprim may affect PCr concentration, whereas prednisone and calcineurin inhibitors may affect CystC concentration). This study evaluated the performance of six formulas in pediatric kidney transplant recipients.Design, setting, participants, & measurements The study used PCr-based formulas (bedside Schwartz, SchwartzLyon), CystC-based formulas (Hoek, Filler), and combined PCr-CystC-based formulas (CKD in Children [CKiD] 2012 and Zappitelli). The performance of these formulas was compared using inulin clearance as reference and assessed according to CKD stages in a historical cohort that included 73 pediatric kidney transplant recipients (199 measurements). The ability of the formulas to identify GFRs,60, ,75, and ,90 ml/min per 1.73 m 2 was assessed.Results At measured GFR (mGFR) $90 ml/min per 1.73 m 2 (nine patients; 23 measurements), the Zappitelli formula had the highest 30% accuracy (P30) (95% [95% confidence interval (95% CI), 87% to 100%]) and the bedside Schwartz had the highest 10% accuracy (P10) (56% [95% CI, 32% to 72%]). At mGFR$60 and ,90 ml/min per 1.73 m 2 (22 patients; 91 measurements), all formulas had P30 values .80%. However, only the CKiD 2012 formula had a P10 value .50%. At mGFR,60 ml/min per 1.73 m 2 (42 patients; 85 measurements), the CKiD 2012 and Schwartz-Lyon formulas had the highest P10 (45% [95% CI, 34% to 55%] and 43% [95% CI, 33% to 54%]) and P30 (90% [95% CI, 84% to 97%] and 91% [95% CI, 86% to 98%]). All studied equations except Hoek and Filler had areas under the receiver-operating characteristic curves significantly .90% in discriminating patients with renal dysfunction at various CKD stages (GFR,60, ,75, and ,90 ml/min per 1.73 m 2 ).Conclusions In pediatric kidney transplant recipients, the CKiD 2012 formula had the best performance at mGFRs,90 ml/min per 1.73 m 2 . CystC-based formulas were not superior to PCr-based formulas.

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The relationship between serum creatinine, serum cystatin C and glomerular filtration rate in pediatric renal transplant recipients: A pilot study

Cited by 29 publications

References 16 publications

Estimation of glomerular filtration rate in paediatric cancer patients using 51CR-EDTA population pharmacokinetics

Estimation of glomerular filtration rate in paediatric cancer patients using 51CR-EDTA population pharmacokinetics

Cystatin C: current position and future prospects

Accuracy of Different Equations in Estimating GFR in Pediatric Kidney Transplant Recipients

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