■血清肌酐和胱抑素C用于估计肾小球滤过率,但基于肌酐的估计肾小球滤过率(eGFRcr),基于胱抑素C的估计肾小球滤过率(eGFRcys),基于肌酐和胱抑素C的联合估计肾小球滤过率(eGFRcr-cys)通常是不同的,尤其是老年人。我们调查了与测量的肾小球滤过率(mGFR)相比,估计的肾小球滤过率(eGFR)更准确且偏差更小。
■柏林倡议研究的诊断测试研究。
研究人群包括657名年龄在70岁或以上的人,他们进行了碘海醇血浆清除率(mGFR)和血清肌酐和胱抑素C测量:567名社区居民参与者和90名血清肌酐≥1.5mg/dL。
■我们根据eGFRcys-eGFRcr的差异定义了3组:是否<-5mL/min/1.73m2(较低的eGFRcys),在5毫升/分钟/1.73平方米(参考)内,或≥5毫升/分钟/1.73平方米(较低的eGFRcr)。eGFRcr,eGFRcys,将eGFRcr-cys与mGFR进行比较以评估偏倚和准确性。
■具有95%CIs和准确性(eGFR值在mGFR的±30%范围内的百分比)的中值偏差(eGFR减去mGFR)。
■平均±标准差年龄为78±6岁;平均eGFRcys,eGFRcr,eGFRcr-cys分别为59±23、64±20和61±22mL/min/1.73m2,平均mGFR为56±19mL/min。一半的参与者属于eGFRcys较低的组(n=337,51%)。其中,eGFRcys的中位数偏倚最低(中位数偏倚,-2.7;95%CI,-3.8至-1.9)与其他eGFR方程相比。相反,在较低的eGFR组(n=121,18%),eGFRcr的中位数偏倚与eGFRcy和eGFRcr-cys相比最低(2.9;[95%CI,0.9-4.8]vs13.8[95%CI,11.4-15.6]和9.5[95%CI,7.7-11.0],分别)。在较低的eGFRcr组中,eGFRcr的准确性(eGFR值在mGFR的±30%以内的百分比)为93%,在较低的eGFRcys组中,eGFRcr为92%,而eGFRcr-cys为94%。
■在年轻人群中的普适性未经测试。
■在老年人中,比较各组时,eGFRcys和eGFRcr之间较低的eGFR对mGFR的估计更准确,偏差更小.
UNASSIGNED: Serum creatinine and cystatin C are used to estimate glomerular filtration rate, but creatinine-based estimated glomerular filtration rate (eGFRcr), cystatin C-based estimated glomerular filtration rate (eGFRcys), and combined creatinine- and cystatin C-based estimated glomerular filtration rate (eGFRcr-cys) are often divergent, particularly in older adults. We investigated which estimated glomerular filtration rate (eGFR) was more accurate and less biased compared with measured glomerular filtration rate (mGFR).
UNASSIGNED: A diagnostic test study from the Berlin Initiative Study.
UNASSIGNED: The study population included 657 individuals aged 70 years or older with iohexol plasma clearance (mGFR) and serum creatinine and cystatin C measurements: 567 community-dwelling participants and 90 with a serum creatinine of ≥1.5 mg/dL.
UNASSIGNED: We defined 3 groups on the basis of the difference eGFRcys - eGFRcr: whether < -5 mL/min/1.73 m2 (lower eGFRcys), within 5 mL/min/1.73 m2 (reference), or ≥ 5 mL/min/1.73 m2 (lower eGFRcr). eGFRcr, eGFRcys, and eGFRcr-cys were compared to mGFR to assess bias and accuracy.
UNASSIGNED: Median bias (eGFR minus mGFR) with 95% CIs and accuracy (percentage of eGFR values within ±30% of mGFR).
UNASSIGNED: The mean ± standard deviation age was 78 ± 6 years; the mean eGFRcys, eGFRcr, and eGFRcr-cys were 59 ± 23, 64 ± 20, and 61 ± 22 mL/min/1.73 m2, respectively, and the mean mGFR was 56 ± 19 mL/min. Half of the participants were in the lower eGFRcys group (n=337, 51%). Among them, the median bias for eGFRcys was the lowest (median bias, -2.7; 95% CI, -3.8 to -1.9) compared with the other eGFR equations. Conversely, in the lower eGFRcr group (n=121, 18%), the median bias for eGFRcr was the lowest compared with those for eGFRcys and eGFRcr-cys (2.9; [95% CI, 0.9-4.8] vs 13.8 [95% CI, 11.4-15.6] and 9.5 [95% CI, 7.7-11.0], respectively). Accuracy (percentage of eGFR values within ±30% of mGFR) was 93% for eGFRcr in the lower eGFRcr group and 92% for eGFRcys and 94% for eGFRcr-cys in the lower eGFRcys group.
UNASSIGNED: Untested generalizability in younger populations.
UNASSIGNED: Among older adults, the lower eGFR between eGFRcys and eGFRcr was a more accurate and less biased estimate of mGFR when comparing the groups.