Assessment of creatinine and cystatin C-based eGFR equations in Chinese older adults with chronic kidney disease

Introduction

Glomerular filtration rate (GFR) estimation equations using creatinine and Cystatin-C appear to be superior to those based on creatinine or Cystatin-C in older adults. We sought to compare the performances of those based on creatinine and Cystatin-C in Chinese older adults with chronic kidney disease (CKD).

Methods

A total of 368 Chinese elderly with CKD underwent the dynamic imaging with technetium-⁹⁹m diethylene-triamine-pentaacetic acid (⁹⁹mTc-DTPA), and serum creatinine and Cystatin-C were measured on the same day. The comparison of GFR equations which were creatinine and Cystatin-C-based including chronic kidney disease epidemiology collaboration (CKD-EPI) equation (CKD-EPI-Cr-Cys), Berlin Initiative Study (BIS) equation (BIS-Cr-Cys, also known as BIS-2), MA equation (MA-Cr-Cys), and FENG equation (FENG-Cr-Cys) was conducted.

Results

Four equations overestimated GFR except for BIS-2 equation in mGFR?≥?60 ml/min/1.73 m² (bias: ? 1.40, p?=?0.7) and CKD-EPI-Cr-Cys equation in mGFR?2 (bias: ? 1.82, p?=?0.2) were unbiased. BIS-2 equation had the smallest interquartile range (IQR, ml/min/1.73 m²) from 12.73 in age?2) were seen in BIS-2 equation from 13.22 in age?

Conclusions

BIS-2 equation may be optimal for Chinese older adults with CKD especially in older adults?≥?75 years and with mGFR?≥?30 ml/min/1.73 m², while CKD-EPI-Cr-Cys equation could yield a better performance than BIS-2 equation, especially in those?2.