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Is the Chronic Kidney Disease Epidemiology Collaboration four‐level race equation better than the cystatin C equation?
Author(s) -
DU XIN,
LIU LIN,
HU BO,
WANG FENG,
WAN XIN,
JIANG LINGLIN,
ZHANG RUISHENG,
CAO CHANGCHUN
Publication year - 2012
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2012.01568.x
Subject(s) - renal function , cystatin c , medicine , kidney disease , urology , creatinine , endocrinology , population , environmental health
Aim: To evaluate the Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) four‐level race equation in the assessment of glomerular filtration rate (GFR) in Chinese people with chronic kidney disease (CKD), which was published in 2011, compared with the cystatin C‐based GFR estimation equation (CysC GFR) and the combination of CysC and serum creatinine equation (CysC‐Scr GFR). Methods: The CKD‐EPI four‐level race equation estimated GFR (CKD‐EPI GFR) was compared with the CysC GFR and CysC‐Scr GFR. Three equations were compared with body surface area (BSA) standardized GFR (sGFR), which was measured by 99m Tc‐DTPA renal dynamic imaging method in 111 CKD cases. Results: A statistically significant correlation was found between sGFR and CKD‐EPI GFR, CysC GFR and CysC‐Scr GFR. Three estimated GFR (eGFR) equations of 30% accuracy were 58.6%, 56.8% and 63.5%, respectively. Average deviations of eGFR from sGFR were 2.34, 1.19, and 1.32 (mL/min per 1.73 m 2 ) ( P > 0.05), respectively. There was no significant deviation in the CKD from stages 1 to 5 in CKD‐EPI GFR and CysC‐Scr GFR. However, when estimated by CysC GFR, the deviation was increased, with the value of 12.41 mL/min per 1.73 m 2 ( P = 0.002) in CKD stage 5. Conclusion: Our results showed that in a Chinese population with CKD, CKD‐EPI GFR, CysC GFR and CysC‐Scr GFR of bias and overall accuracy of 30% were very similar. There was little advantage in adding Asian coefficient to modifying the CKD‐EPI equation. CysC GFR overestimated GFR in patients with CKD stages 4 and 5.