Estimating glomerular filtration rate by serum creatinine or/and cystatin C equations: An analysis of multi‐centre Chinese subjects

Ye, Xiaoshuang; Liu, Xun; Song, Dan; Zhang, Xiaoxuan; Zhu, Bei; Wei, Lu; Pei, Xiaohua; Wu, Jianqing; Lou, Tanqi; Zhao, Weihong

doi:10.1111/nep.12636

Cited by 22 publications

(13 citation statements)

References 27 publications

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“…Five studies showed uncertain risk of bias in the flow and timing. Some studies [ 16 , 18 , 22 , 23 , 25 ] enrolled mostly female or male patients, who might not be representative of the target population, and so potential spectrum bias existed.…”

Section: Resultsmentioning

confidence: 99%

The diagnostic value of serum creatinine and cystatin c in evaluating glomerular filtration rate in patients with chronic kidney disease: a systematic literature review and meta-analysis

Qiu

Liu

et al. 2017

Oncotarget

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BackgroundSerum biomarkers, such as serum creatinine (SCr) and serum cystatin C (SCysC), have been widely used to evaluate renal function in patients who have chronic kidney disease (CKD).ObjectiveThis article aims to assess the value of determining SCr and SCysC levels in patients that have long-term kidney disease. Approaches: MEDLINE, EmBase, the Cochrane Library and other databases were searched using both MeSH terms and text words to collect research that assessed the diagnostic value of using SCr and SCysC to evaluate Glomerular Filtration Rate (GFR) in patients with CKD. Data were converted into fourfold tables. Summary Receiver Operating Characteristic Curves and meta-analyses were accomplished via Meta-Disc version 1.4.ResultsIn total, 21 relevant articles involving 3112 study subjects were included in our review. Results showed that the collective sensitivity for SCr and SCysC was 0.77 (95% CI: 0.69–0.84) and 0.87 (95% CI: 0.82–0.91), respectively. The pooled specificity for SCr and SCysC was 0.91 (95% CI: 0.86–0.94) and 0.87 (95% CI: 0.82–0.91), respectively. Subgroup analyses demonstrated that when GFR cut-off values are set to 60 (ml/min/1.73 m2), the pooled sensitivity is 0.94 (95% CI: 0.90–0.96) for SCysC and 0.75 (95% CI: 0.68–0.82) for SCr.ConclusionsThe diagnostical accuracy for impaired kidney function favors SCysC. Confidence intervals for the pooled sensitivity and specificity for SCr and SCysC overlap. However, SCysC is more sensitive for estimating GFR than SCr when GFR cut-off values are set to 60 (ml/min/1.73 m2).

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Section: Resultsmentioning

confidence: 99%

The diagnostic value of serum creatinine and cystatin c in evaluating glomerular filtration rate in patients with chronic kidney disease: a systematic literature review and meta-analysis

Qiu

Liu

et al. 2017

Oncotarget

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“…One is serum cystatin C-base eGFR equation and the other is cystatin C combined with creatinine-based equation. The precision of the two equations has been validated [ 35 , 36 ]. In the present study, the eGFRs derived from the three equations were all closely related to carotid WSS.…”

Section: Discussionmentioning

confidence: 99%

Carotid artery wall shear stress is independently correlated with renal function in the elderly

et al. 2018

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Hemodynamic has increasingly been regarded as an important factor of renal function. However, the relationship between carotid artery wall shear stress (WSS) and renal function is not clarified. To investigate the relationship between carotid WSS and renal function, we recruited 761 older subjects aged 60 years and over from community-dwelling in the Shandong area, China. Carotid WSS, endothelial function, and estimated glomerular filtration rate (eGFR) were assessed in all subjects. Subjects were grouped by the interquartile of the carotid artery mean WSS. We found that the eGFRs derived from serum creatinine and/or cystatin C using three CKD-EPI equations were significantly higher and albumin/creatinine ratio was lower in the higher interquartile groups than in the lower interquartile groups (P <0.05). The mean WSS was independently correlated with eGFRs even after adjustment for confounders. Similar findings were found between carotid artery peak WSS and eGFRs and albumin/creatinine ratio. In addition, we found that endothelial function was strongly related to carotid WSS and renal function after adjustment for confounders. In conclusion, there is an independent correlation of carotid WSS with renal function in the elderly. The local rheologic forces may play an important role in renal function changing. The correlation may be mediated by regulation of endothelial function.

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“…Using fasting serum to derive serum creatinine concentration (Scr, mg/dL), we calculated estimated glomerular filtration rates (eGFR), using the following set of equations [32] which were modified based on the Chronic Kidney Disease-Epidemiology (CKD-EPI) equations and acquired the best performance among serum creatinine-based equations validated among Chinese population in Ye et al [33]. Reduced renal function was defined as eGFR of <60 mL/min/1.73 m 2 [34].…”

Section: Methodsmentioning

confidence: 99%

The association between urbanization and reduced renal function: findings from the China Health and Nutrition Survey

et al. 2017

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BackgroundWhile chronic kidney disease (CKD) is a growing public health concern in low- and middle-income countries, such as China, few studies have investigated the association between urbanization and the occurrence of CKD in those countries.MethodsWe investigated the association between urbanization and estimated glomerular filtration rate (eGFR), an important CKD risk marker. Data came from the China Health and Nutrition Survey wave 2009, in which we collected fasting serum, individual and household data along with community level urbanization data, which was used to derive a study-specific urbanization measure, in 218 communities across nine provinces. A total of 3644 men and 4154 women participants aged 18 years or older were included in the analysis. Reduced renal function was defined as eGFR of less than 60 mL/min/1.73 m2 measured using serum creatinine concentration (mg/dL).ResultsAfter adjusting for socio-demographic (e.g., age, education and household income), a sex-stratified multilevel logistic model revealed that living in a more urbanized community was associated with higher odds of reduced eGFR (odds ratio [OR] = 1.38 per one-standard deviation [SD] increase in the CHNS specific urbanization index, 95% confidence interval [CI] = 1.11–1.73 for men; OR = 1.35, 95% CI = 1.11–1.62 for women). After adjusting for behavioral variables (i.e., alcohol consumption, smoking, physical activity and diet), as well as obesity and cardiometabolic risk factors, the association was attenuated in men (OR = 1.25, 95% CI = 0.98–1.59), but remained statistically significant in women (OR = 1.24, 95% CI = 1.01–1.52).ConclusionOur findings suggest that living in an urban environment is linked with higher odds of reduced renal function independently of behavioral and cardiometabolic risk factors, which have been shown to increase along with urbanization.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-017-0577-7) contains supplementary material, which is available to authorized users.

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Estimating glomerular filtration rate by serum creatinine or/and cystatin C equations: An analysis of multi‐centre Chinese subjects

Abstract: The Fengscr-cys equation appeared to achieve the best performance for GFR estimation in overall Chinese adult patients. However, further research is warranted to improve the accuracy of available equations in GFR less than 60 mL/min per 1.73 m(2) individuals.

Cited by 22 publications

References 27 publications

The diagnostic value of serum creatinine and cystatin c in evaluating glomerular filtration rate in patients with chronic kidney disease: a systematic literature review and meta-analysis

The diagnostic value of serum creatinine and cystatin c in evaluating glomerular filtration rate in patients with chronic kidney disease: a systematic literature review and meta-analysis

Carotid artery wall shear stress is independently correlated with renal function in the elderly

The association between urbanization and reduced renal function: findings from the China Health and Nutrition Survey

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