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Proteomics and Protein Markers |
1 Department of Clinical Chemistry, 2
Competence Centre for Clinical Research, and 3
Department of Nephrology, University Hospital, Lund, Sweden.
4 Department of Radiology, Lasarettet, Trelleborg, Sweden.
5 Department of Nephrology and Transplantation, University Hospital, Malmö, Sweden.
aAddress correspondence to this author at: Department of Clinical Chemistry, University Hospital, S-22185 Lund, Sweden. Fax 46-46130064; e-mail anders.grubb{at}klinkem.lu.se.
Background: Serum creatinine is the most commonly used marker for estimation of glomerular filtration rate (GFR). To compensate for its drawbacks as a GFR marker, several prediction equations including several parameters are being used, with the Modification of Diet in Renal Disease (MDRD), Schwartz, and Counahan–Barratt equations being the ones most widely accepted for estimation of relative GFR in mL · min–1 · (1.73 m2)–1. The present study analyzes whether these GFR prediction equations for adults and children might be replaced by simple prediction equations based on plasma concentrations of cystatin C.
Methods: Data from 536 patients (0.3–93 years), consecutively referred for determination of GFR by an invasive gold standard procedure, were used for the analysis. Calculations of bias (median percentage of error), correlation (adjusted R2), and percentage of estimates within 30% and 50% of measured GFR were used in the comparisons.
Results: A cystatin C–based prediction equation using only concentration in mg/L and a prepubertal factor: GFR [mL · min–1 · (1.73 m2)–1] = 84.69 x cystatin C (mg/L)–1.680 x 1.384 (if a child <14 years) assessed GFR equally well or better than the simplified MDRD, the Schwartz, and the Counahan–Barratt prediction equations for the adult (
18 years) and juvenile groups of the investigated cohort. Age did not influence the cystatin C–based prediction equation for adults, whereas gender did, but with a factor close to unity (0.948 for females).
Conclusion: A GFR prediction equation based solely on cystatin C (in mg/L) and a prepubertal factor might replace the simplified MDRD prediction equation for adults and the Schwartz and Counahan–Barratt prediction equations for children.
The following articles in journals at HighWire Press have cited this article:
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  A. G. Abraham, G. J. Schwartz, S. Furth, B. A. Warady, and A. Munoz Longitudinal Formulas to Estimate GFR in Children with CKD Clin. J. Am. Soc. Nephrol., November 1, 2009; 4(11): 1724 - 1730. [Abstract] [Full Text] [PDF]
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G. J. Schwartz and D. F. Work Measurement and Estimation of GFR in Children and Adolescents Clin. J. Am. Soc. Nephrol., November 1, 2009; 4(11): 1832 - 1843. [Abstract] [Full Text] [PDF]
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J. G. Smith, C. Newton-Cheh, B. Hedblad, J. Struck, N. G. Morgenthaler, A. Bergmann, T. J. Wang, and O. Melander Distribution and Correlates of Midregional Proadrenomedullin in the General Population Clin. Chem., August 1, 2009; 55(8): 1593 - 1595. [Full Text] [PDF]
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 A. S. Levey, L. A. Stevens, C. H. Schmid, Y. Zhang, A. F. Castro III, H. I. Feldman, J. W. Kusek, P. Eggers, F. Van Lente, T. Greene, et al. A New Equation to Estimate Glomerular Filtration Rate Ann Intern Med, May 5, 2009; 150(9): 604 - 612. [Abstract] [Full Text] [PDF]
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 U. Alehagen, U. Dahlstrom, and T. L. Lindahl Cystatin C and NT-proBNP, a powerful combination of biomarkers for predicting cardiovascular mortality in elderly patients with heart failure: results from a 10-year study in primary care Eur J Heart Fail, April 1, 2009; 11(4): 354 - 360. [Abstract] [Full Text] [PDF]
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 G. J. Schwartz, A. Munoz, M. F. Schneider, R. H. Mak, F. Kaskel, B. A. Warady, and S. L. Furth New Equations to Estimate GFR in Children with CKD J. Am. Soc. Nephrol., March 1, 2009; 20(3): 629 - 637. [Abstract] [Full Text] [PDF]
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D. Groesbeck, A. Kottgen, R. Parekh, E. Selvin, G. J. Schwartz, J. Coresh, and S. Furth Age, Gender, and Race Effects on Cystatin C Levels in US Adolescents Clin. J. Am. Soc. Nephrol., November 1, 2008; 3(6): 1777 - 1785. [Abstract] [Full Text] [PDF]
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S. Gourishankar, M. Courtney, G. S. Jhangri, G. Cembrowski, and N. Pannu Serum cystatin C performs similarly to traditional markers of kidney function in the evaluation of donor kidney function prior to and following unilateral nephrectomy Nephrol. Dial. Transplant., September 1, 2008; 23(9): 3004 - 3009. [Abstract] [Full Text] [PDF]
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D. Xie, M. M. Joffe, S. M. Brunelli, G. Beck, G. M. Chertow, J. C. Fink, T. Greene, C.-y. Hsu, J. W. Kusek, R. Landis, et al. A Comparison of Change in Measured and Estimated Glomerular Filtration Rate in Patients with Nondiabetic Kidney Disease Clin. J. Am. Soc. Nephrol., September 1, 2008; 3(5): 1332 - 1338. [Abstract] [Full Text] [PDF]
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M. Tidman, P. Sjostrom, and I. Jones A Comparison of GFR estimating formulae based upon s-cystatin C and s-creatinine and a combination of the two Nephrol. Dial. Transplant., January 1, 2008; 23(1): 154 - 160. [Abstract] [Full Text] [PDF]
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 B. Lambermont and V. D'Orio Cystatin C blood level as a risk factor for death after heart surgery Eur. Heart J., November 2, 2007; 28(22): 2818 - 2818. [Full Text] [PDF]
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D. Ledoux, M. Monchi, J.-P. Chapelle, and P. Damas Cystatin C blood level as a risk factor for death after heart surgery: reply Eur. Heart J., November 2, 2007; 28(22): 2818 - 2819. [Full Text] [PDF]
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 D. M. Maahs, L. G. Ogden, A. Kretowski, J. K. Snell-Bergeon, G. L. Kinney, T. Berl, and M. Rewers Serum Cystatin C Predicts Progression of Subclinical Coronary Atherosclerosis in Individuals With Type 1 Diabetes Diabetes, November 1, 2007; 56(11): 2774 - 2779. [Abstract] [Full Text] [PDF]
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M. Schou, F. Gustafsson, C. N. Kistorp, P. Corell, A. Kjaer, and P. R. Hildebrandt Effects of Body Mass Index and Age on N-Terminal Pro Brain Natriuretic Peptide Are Associated with Glomerular Filtration Rate in Chronic Heart Failure Patients Clin. Chem., November 1, 2007; 53(11): 1928 - 1935. [Abstract] [Full Text] [PDF]
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A. Zahran, M. Qureshi, and A. Shoker Comparison between creatinine and cystatin C-based GFR equations in renal transplantation Nephrol. Dial. Transplant., September 1, 2007; 22(9): 2659 - 2668. [Abstract] [Full Text] [PDF]
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M. S. MacGregor How common is early chronic kidney disease?: A Background Paper prepared for the UK Consensus Conference on Early Chronic Kidney Disease Nephrol. Dial. Transplant., September 1, 2007; 22(suppl_9): ix8 - ix18. [Full Text] [PDF]
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F. J. Hoek, J. C. Korevaar, F. W. Dekker, E. W. Boeschoten, and R. T. Krediet Estimation of residual glomerular filtration rate in dialysis patients from the plasma cystatin C level Nephrol. Dial. Transplant., June 1, 2007; 22(6): 1633 - 1638. [Abstract] [Full Text] [PDF]
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L. Pucci, S. Triscornia, D. Lucchesi, C. Fotino, G. Pellegrini, E. Pardini, R. Miccoli, S. Del Prato, and G. Penno Cystatin C and Estimates of Renal Function: Searching for a Better Measure of Kidney Function in Diabetic Patients Clin. Chem., March 1, 2007; 53(3): 480 - 488. [Abstract] [Full Text] [PDF]
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 M. Zaffanello, M. Franchini, and V. Fanos Is Serum Cystatin-C a Suitable Marker of Renal Function in Children? Ann. Clin. Lab. Sci., January 1, 2007; 37(3): 233 - 240. [Abstract] [Full Text] [PDF]
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L. F. Fried, M. L. Biggs, M. G. Shlipak, S. Seliger, B. Kestenbaum, C. Stehman-Breen, M. Sarnak, D. Siscovick, T. Harris, J. Cauley, et al. Association of Kidney Function with Incident Hip Fracture in Older Adults J. Am. Soc. Nephrol., January 1, 2007; 18(1): 282 - 286. [Abstract] [Full Text] [PDF]
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J. Coresh and B. Astor Decreased Kidney Function in the Elderly: Clinical and Preclinical, Neither Benign Ann Intern Med, August 15, 2006; 145(4): 299 - 301. [Full Text] [PDF]
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 L. A. Stevens, J. Coresh, T. Greene, and A. S. Levey Assessing kidney function--measured and estimated glomerular filtration rate. N. Engl. J. Med., June 8, 2006; 354(23): 2473 - 2483. [Full Text] [PDF]
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 R Marouf, O Mojiminiyi, N Abdella, M Kortom, and H Al Wazzan Comparison of renal function markers in Kuwaiti patients with sickle cell disease. J. Clin. Pathol., April 1, 2006; 59(4): 345 - 351. [Abstract] [Full Text] [PDF]
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A. Grubb and G. Nordin Notable Steps in Obtaining Improved Estimates for Glomerular Filtration Rate Clin. Chem., February 1, 2006; 52(2): 169 - 170. [Full Text] [PDF]
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J. Westhuyzen Cystatin C: a Promising Marker and Predictor of Impaired Renal Function Ann. Clin. Lab. Sci., January 1, 2006; 36(4): 387 - 394. [Abstract] [Full Text] [PDF]
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P. J. Twomey and M. H. Kroll Errors in the Assessment of Estimated Glomerular Filtration Rate Clin. Chem., January 1, 2006; 52(1): 153 - 153. [Full Text] [PDF]
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A. Grubb and J. Bjork Errors in the Assessment of Estimated Glomerular Filtration Rate: Reply Clin. Chem., January 1, 2006; 52(1): 154 - 155. [Full Text] [PDF]
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L. F. Fried, R. Katz, M. J. Sarnak, M. G. Shlipak, P. H.M. Chaves, N. S. Jenny, C. Stehman-Breen, D. Gillen, A. J. Bleyer, C. Hirsch, et al. Kidney Function as a Predictor of Noncardiovascular Mortality J. Am. Soc. Nephrol., December 1, 2005; 16(12): 3728 - 3735. [Abstract] [Full Text] [PDF]
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L. Risch, H. Drexel, and A. R. Huber Differences in Glomerular Filtration Rate Estimates by 2 Cystatin C-Based Equations Clin. Chem., November 1, 2005; 51(11): 2211 - 2212. [Full Text] [PDF]
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