Article (Scientific journals)
GFR Estimation Using Standardized Cystatin C in Kidney Transplant Recipients
Masson, Ingrid; Maillard, Nicolas; Tack, Ivan et al.
2013In American Journal of Kidney Diseases, 61 (2), p. 279-284
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Keywords :
Glomerular filtration rate; inulin; renal transplantation; cystatin C
Abstract :
[en] Background: The utility of serum cystatin C (SCysC) as a filtration marker in kidney transplantation is uncertain. We took advantage of the recent validation of a reference calibrator for SCysC and of newly developed CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equations (2012) expressed for use with standardized SCysC level to reassess the performance of SCysC as a filtration marker in kidney transplant recipients. Study Design: Study of diagnostic test accuracy. Setting & Participants: 670 kidney transplant recipients from 3 centers undergoing glomerular filtration rate (GFR) measurements from December 2006 to November 2012. Index Test: Estimated GFR (eGFR) using the 2012 SCysC-based and serum creatinine (SCr)/SCysCbased CKD-EPI equations (eGFRcys and eGFRcr-cys, respectively) and the 2009 SCr-based CKD-EPI equation (eGFRcr), with SCysC and SCr measured at a single laboratory between April 2011 and June 2011. Reference Test: Measured GFR (mGFR) using urinary clearance of inulin. Results: Bias (the difference between mGFR and eGFR) was significantly smaller for eGFRcys and eGFRcr-cys versus eGFRcr ( 2.82 and 0.54 vs 4.4 mL/min/1.73 m2, respectively; P 0.001). Precision (standard deviation of the mean bias) also was better for eGFRcys and eGFRcr-cys versus eGFRcr (12 and 11 vs 13 mL/min/1.73 m2 [P 0.001 for both comparisons]). Accuracy (percentage of GFR estimates within 30% of mGFR) was greater for eGFRcys and eGFRcr-cys versus eGFRcr (81% and 86% vs 75%, respectively [P 0.004 and P 0.001]). Net reclassification index with respect to mGFR of 30 mL/min/1.73 m2 for eGFRcr-cys and eGFRcys versus eGFRcr was 18.8% [95% CI, 8.6%-28.9%] and 22.5% [95% CI, 10.2%-34.9%]. Limitations: Patients were exclusively of European descent; association with transplant outcome was not evaluated. Conclusions: Our data validate the use of both the newly developed SCysC-based and SCr/SCysC-based CKD-EPI equations (2012) in kidney transplant recipients. Both equations perform better than the SCr-based CKD-EPI equation (2009).
Disciplines :
Laboratory medicine & medical technology
Author, co-author :
Masson, Ingrid
Maillard, Nicolas
Tack, Ivan
Thibaudin, Lise
Dubourg, Laurence
DELANAYE, Pierre  ;  Centre Hospitalier Universitaire de Liège - CHU > Néphrologie
CAVALIER, Etienne  ;  Centre Hospitalier Universitaire de Liège - CHU > Chimie médicale
Bonneau, Christine
Kamar, Nassim
Morelon, Emmanuel
Moranne, Olivier
Alamartine, Eric
Mariat, Christophe
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Title :
GFR Estimation Using Standardized Cystatin C in Kidney Transplant Recipients
Publication date :
Journal title :
American Journal of Kidney Diseases
Publisher :
W.B. Saunders, Philadelphia, United States - Pennsylvania
Volume :
Issue :
Pages :
Peer reviewed :
Peer Reviewed verified by ORBi
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since 27 March 2013


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