PDF(Pubmed)
Abstract：
UNASSIGNED: Use of cystatin C in addition to creatinine to estimate glomerular filtration rate (estimated glomerular filtration rate based on cystatin C [eGFRcys] and estimated glomerular filtration rate based on creatinine [eGFRcr], respectively) is increasing. When eGFRcr and eGFRcys are discordant, it is not known which is more accurate, leading to uncertainty in clinical decision making.
UNASSIGNED: Cross-sectional analysis.
UNASSIGNED: Four thousand fifty participants with measured glomerular filtration rate (mGFR) from 12 studies in North America and Europe.
UNASSIGNED: Serum creatinine and serum cystatin C.
UNASSIGNED: Performance of creatinine-based and cystatin C-based glomerular filtration rate estimating equations compared to mGFR.
UNASSIGNED: We evaluated the accuracy of eGFRcr, eGFRcys, and the combination (eGFRcr-cys) compared to mGFR according to the magnitude of the difference between eGFRcr and eGFRcys (eGFRdiff). We used CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equations to estimate glomerular filtration rate. eGFRdiff was defined as eGFRcys minus eGFRcr and categorized as less than -15, -15 to <15, and ≥15 mL/min/1.73 m2 (negative, concordant, and positive groups, respectively). We compared bias (median of mGFR minus eGFR) and the percentage of eGFR within 30% of mGFR.
UNASSIGNED: Thirty percent of participants had discordant eGFRdiff (21.0% and 9.6% negative and positive eGFRdiffs, respectively). In the concordant eGFRdiff group, all equations displayed similar accuracy. In the negative eGFRdiff groups, eGFRcr had a large overestimation of mGFR (-13.4 [-14.5 to -12.2] mL/min/1.73 m2) and eGFRcys had a large underestimation (9.9 [9.1-11.2] mL/min/1.73m2), with opposite results in the positive eGFRdiff group. In both negative and positive eGFRdiff groups, eGFRcr-cys was more accurate than either eGFRcr or eGFRcys. These results were largely consistent across age, sex, race, and body mass index.
UNASSIGNED: Few participants with major comorbid conditions.
UNASSIGNED: Discordant eGFRcr and eGFRcys are common. eGFR using the combination of creatinine and cystatin C provides the most accurate estimates among persons with discordant eGFRcr or eGFRcys.
UNASSIGNED: Cross-sectional analysis.
UNASSIGNED: Four thousand fifty participants with measured glomerular filtration rate (mGFR) from 12 studies in North America and Europe.
UNASSIGNED: Serum creatinine and serum cystatin C.
UNASSIGNED: Performance of creatinine-based and cystatin C-based glomerular filtration rate estimating equations compared to mGFR.
UNASSIGNED: We evaluated the accuracy of eGFRcr, eGFRcys, and the combination (eGFRcr-cys) compared to mGFR according to the magnitude of the difference between eGFRcr and eGFRcys (eGFRdiff). We used CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equations to estimate glomerular filtration rate. eGFRdiff was defined as eGFRcys minus eGFRcr and categorized as less than -15, -15 to <15, and ≥15 mL/min/1.73 m2 (negative, concordant, and positive groups, respectively). We compared bias (median of mGFR minus eGFR) and the percentage of eGFR within 30% of mGFR.
UNASSIGNED: Thirty percent of participants had discordant eGFRdiff (21.0% and 9.6% negative and positive eGFRdiffs, respectively). In the concordant eGFRdiff group, all equations displayed similar accuracy. In the negative eGFRdiff groups, eGFRcr had a large overestimation of mGFR (-13.4 [-14.5 to -12.2] mL/min/1.73 m2) and eGFRcys had a large underestimation (9.9 [9.1-11.2] mL/min/1.73m2), with opposite results in the positive eGFRdiff group. In both negative and positive eGFRdiff groups, eGFRcr-cys was more accurate than either eGFRcr or eGFRcys. These results were largely consistent across age, sex, race, and body mass index.
UNASSIGNED: Few participants with major comorbid conditions.
UNASSIGNED: Discordant eGFRcr and eGFRcys are common. eGFR using the combination of creatinine and cystatin C provides the most accurate estimates among persons with discordant eGFRcr or eGFRcys.
摘要：
■使用胱抑素C和肌酐来估计肾小球滤过率（基于胱抑素C[eGFRcys]的估计肾小球滤过率和基于肌酐[eGFRcr]的估计肾小球滤过率，分别)正在增加。当eGFRcr和eGFRcy不一致时，不知道哪个更准确，导致临床决策的不确定性。
■横截面分析。
■在北美和欧洲的12项研究中，有4000名参与者测量了肾小球滤过率（mGFR）。
■血清肌酐和血清胱抑素C
■基于肌酐和基于胱抑素C的肾小球滤过率估算方程与mGFR相比的性能。
■我们评估了eGFRcr的准确性，eGFRcys,和根据eGFRcr和eGFRcys之间的差异的幅度(eGFRdiff)将组合(eGFRcr-cys)与mGFR进行比较。我们使用CKD-EPI（慢性肾脏病流行病学合作）方程来估计肾小球滤过率。eGFRdiff定义为eGFRcys减去eGFRcr，分类为小于-15、-15至<15和≥15mL/min/1.73m2(负，和谐，和积极的团体，分别)。我们比较了偏倚（mGFR的中位数减去eGFR）和eGFR在mGFR的30％以内的百分比。
■30％的参与者有不一致的eGFRdiff（21.0％和9.6％的阴性和阳性eGFRdiffs，分别)。在一致的eGFRdiff组中，所有方程都显示出相似的精度。在负eGFRdiff组中，eGFRcr对mGFR有很大的高估（-13.4[-14.5至-12.2]mL/min/1.73m2），eGFRcys有很大的低估（9.9[9.1-11.2]mL/min/1.73m2），在eGFRdiff阳性组中结果相反。在阴性和阳性eGFRdiff组中，eGFRcr-cys比eGFRcr或eGFRcys更准确。这些结果在年龄上基本一致，性别,种族,和体重指数。
■很少有参与者患有重大合并症。
■不一致的eGFRcr和eGFRcy是常见的。使用肌酐和胱抑素C的组合的eGFR在eGFRcr或eGFRcys不一致的人中提供了最准确的估计。
■横截面分析。
■在北美和欧洲的12项研究中，有4000名参与者测量了肾小球滤过率（mGFR）。
■血清肌酐和血清胱抑素C
■基于肌酐和基于胱抑素C的肾小球滤过率估算方程与mGFR相比的性能。
■我们评估了eGFRcr的准确性，eGFRcys,和根据eGFRcr和eGFRcys之间的差异的幅度(eGFRdiff)将组合(eGFRcr-cys)与mGFR进行比较。我们使用CKD-EPI（慢性肾脏病流行病学合作）方程来估计肾小球滤过率。eGFRdiff定义为eGFRcys减去eGFRcr，分类为小于-15、-15至<15和≥15mL/min/1.73m2(负，和谐，和积极的团体，分别)。我们比较了偏倚（mGFR的中位数减去eGFR）和eGFR在mGFR的30％以内的百分比。
■30％的参与者有不一致的eGFRdiff（21.0％和9.6％的阴性和阳性eGFRdiffs，分别)。在一致的eGFRdiff组中，所有方程都显示出相似的精度。在负eGFRdiff组中，eGFRcr对mGFR有很大的高估（-13.4[-14.5至-12.2]mL/min/1.73m2），eGFRcys有很大的低估（9.9[9.1-11.2]mL/min/1.73m2），在eGFRdiff阳性组中结果相反。在阴性和阳性eGFRdiff组中，eGFRcr-cys比eGFRcr或eGFRcys更准确。这些结果在年龄上基本一致，性别,种族,和体重指数。
■很少有参与者患有重大合并症。
■不一致的eGFRcr和eGFRcy是常见的。使用肌酐和胱抑素C的组合的eGFR在eGFRcr或eGFRcys不一致的人中提供了最准确的估计。
