[en] [en] BACKGROUND AND HYPOTHESIS: The estimation of glomerular filtration rate (GFR) is one main tool to detect renal disease. The most used biomarker remains serum creatinine and the European Kidney Function Consortium (EKFCcrea) equation is the most validated in Europe. More recently, cystatin C, has been proposed. We studied the performances of the EKFC equations in a large cohort of subjects according to their diabetic status.
METHODS: Four cohorts from the EKFC dataset were retrospectively considered in which the diabetic status was available. GFR was measured by plasma clearances (mGFR) (iohexol or 51Cr-EDTA). The performance of the equations was assessed by calculating bias, precision (IQR) and P30 (percentage of eGFR-values within ± 30% of mGFR).
RESULTS: In the whole population (n = 6 158), median [IQR] age was 61 [47;72] years, with 45.8% women. Mean mGFR was 60 [39;82] mL/min/1.73m². Compared to non-diabetic individuals (n = 5 124), diabetic patients (n = 1 034) were older, more frequently male, heavier, and had lower mGFR. The performance of the EKFCcys equation was similar to EKFCcrea, but the EKFCcrea+cys had better P30 than the single-biomarker equations. P30 values were substantially lower in diabetic patients than in non-diabetic but, according to a matched analysis, this is mainly explained by the difference in GFR levels between the two populations, not by diabetic status.
CONCLUSION: We showed that equation combining creatinine and cystatin C present a better performance. If accuracy of equations seems better in non-diabetic than in diabetic individuals, it is more due to differences in GFR levels than to the diabetic status.
Disciplines :
Urology & nephrology
Author, co-author :
Delanaye, Pierre ; Université de Liège - ULiège > Département des sciences cliniques ; Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes, France
Björk, Jonas ; Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden ; Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
Vidal-Petiot, Emmanuelle ; Assistance Publique-Hôpitaux de Paris, Bichat Hospital, and Université de Paris, UMR S1138, Cordeliers Research Center, Paris, France
Flamant, Martin; Assistance Publique-Hôpitaux de Paris, Bichat Hospital, and Université de Paris, UMR S1138, Cordeliers Research Center, Paris, France
Ebert, Natalie ; Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany
Schaeffner, Elke; Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany
Grubb, Anders ; Department of Clinical Chemistry, Skåne University Hospital, Lund, Lund University, Sweden
Christensson, Anders ; Department of Nephrology, Skåne University Hospital, Lund University, Malmö, Sweden
Nyman, Ulf; Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden
Stehlé, Thomas ; Université Paris Est Créteil, INSERM, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France ; Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire « Innovative therapy for immune disorders », Créteil, France
Pottel, Hans ; Université de Liège - ULiège > Département des sciences cliniques ; Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
Language :
English
Title :
Diabetic status and the performances of creatinine- and cystatin C-based eGFR equations.
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