Performance of the CKD-EPI creatinine-cystatin C glomerular filtration rate estimation equations in a multiethnic Asian population |
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Authors: | Boon Wee Teo Yun Yin Koh Qi Chun Toh Jialiang Li Arvind Kumar Sinha Borys Shuter Sunil Sethi Evan JC Lee |
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Affiliation: | 1.Department of Medicine, Yong Loo Lin School of Medicine, Singapore;2.Department of Statistics and Applied Probability, National University of Singapore, Singapore;3.Department of Diagnostic Imaging, National University Hospital, Singapore;4.Department of Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore;5.Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore |
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Abstract: | INTRODUCTIONClinical practice guidelines recommend using creatinine-based equations to estimate glomerular filtration rates (GFRs). While these equations were formulated for Caucasian-American populations and have adjustment coefficients for African-American populations, they are not validated for other ethnicities. The Chronic Kidney Disease-Epidemiology Collaborative Group (CKD-EPI) recently developed a new equation that uses both creatinine and cystatin C. We aimed to assess the accuracy of this equation in estimating the GFRs of participants (healthy and with chronic kidney disease [CKD]) from a multiethnic Asian population.METHODSSerum samples from the Asian Kidney Disease Study and the Singapore Kidney Function Study were used. GFR was measured using plasma clearance of 99mTc-DTPA. GFR was estimated using the CKD-EPI equations. The performance of GFR estimation equations were examined using median and interquartile range values, and the percentage difference from the measured GFR.RESULTSThe study comprised 335 participants (69.3% with CKD; 38.5% Chinese, 29.6% Malays, 23.6% Indians, 8.3% others), with a mean age of 53.5 ± 15.1 years. Mean standardised serum creatinine was 127 ± 86 µmol/L, while mean standardised serum cystatin C and mean measured GFR were 1.43 ± 0.74 mg/L and 67 ± 33 mL/min/1.73 m2, respectively. The creatinine-cystatin C CKD-EPI equation performed the best, with an estimated GFR of 67 ± 35 mL/min/1.73 m2.CONCLUSIONThe new creatinine-cystatin C equation estimated GFR with little bias, and had increased precision and accuracy in our multiethnic Asian population. This two-biomarker equation may increase the accuracy of population studies on CKD, without the need to consider ethnicity. |
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Keywords: | Asian chronic kidney disease creatinine cystatin C glomerular filtration rate |
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