Chronic kidney disease staging with cystatin C or creatinine-based formulas: flipping the coin

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
Sergio Luis-LimaEsteban Porrini

Abstract

Chronic kidney disease (CKD) affects 10-13% of the population worldwide. CKD classification stratifies patients in five stages of risk for progressive renal disease based on estimated glomerular filtration rate (eGFR) by formulas and albuminuria. However, the reliability of formulas to reflect real renal function is a matter of debate. The effect of the error of formulas in the CKD classification is unclear, particularly for cystatin C-based equations. We evaluated the reliability of a large number of cystatin C and/or creatinine-based formulas in the definition of the stages of CKD in 882 subjects with different clinical situations over a wide range of glomerular filtration rates (GFRs) (4.2-173.7 mL/min). Misclassification was a constant for all 61 formulas evaluated and averaged 50% for creatinine-based and 35% for cystatin C-based equations. Most of the cases were misclassified as one stage higher or lower. However, in 10% of the subjects, one stage was skipped and patients were classified two stages above or below their real stage. No clinically relevant improvement was observed with cystatin C-based formulas compared with those based on creatinine. The error in the classification of CKD stages by formulas was extremely co...Continue Reading

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Citations

Oct 4, 2019·Nature Reviews. Nephrology·Esteban PorriniGiuseppe Remuzzi
May 26, 2020·Expert Review of Molecular Diagnostics·Stefanie W BenoitPrasad Devarajan
Aug 25, 2020·Annals of Laboratory Medicine·Christian AlbertAnja Haase-Fielitz
Sep 12, 2019·Frontiers in Endocrinology·Danshu XieNan Chen
Oct 12, 2020·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Mara McAdams-DeMarcoDorry L Segev
Jan 27, 2020·Kidney & Blood Pressure Research·Francesco TrevisaniEsteban Porrini
Sep 15, 2021·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Christophe MariatUmberto Maggiore
Dec 25, 2021·Liver International : Official Journal of the International Association for the Study of the Liver·Carlos González-AlayónManuel Hernandez-Guerra

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