Background: Plasma creatinine and creatinine clearance are of limited value for the estimation of renal function in cirrhotics. In these patients, cystatin C (Cys C) has been proposed as an alternative marker of glomerular filtration rate (GFR) and Cys C-based equations for calculation of GFR have been developed in non-cirrhotic patient cohorts.
Methods: We retrospectively analyzed correlation, bias, precision and accuracy of two Cys C-based formulae (Larsson and Hoek) for GFR estimation in comparison with two creatinine-based equations (Cockroft & Gault and MDRD). The Cys C was determined by an immunonephelometric method. The GFR was measured by means of inulin clearance in 44 consecutive patients with liver cirrhosis.
Results: On average, inulin clearance was 28.3 (95% CI: 29.2-41.3 ml/min/1.73 m2). Creatinine as well as Cys C-based equations overestimated the true GFR by 105-154%. However, Cys C-based equations showed significantly lower bias and higher precision than the creatinine-based formulae. Correlation and accuracy tended to be better with the Hoek and Larsson equation than with the Cockroft & Gault or MDRD formulae. Hoek and Larsson equations showed a similar diagnostic performance in all statistical procedures.
Conclusion: Our data suggest a significant improvement of GFR estimation in liver cirrhotics by means of the Cys C-based Hoek and Larsson formulae. However, all estimates remain a crude approximation of true GFR and thus cannot replace gold standard methods.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/ndt/gfi305 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Comparison of Measured Glomerular Filtration Rate Versus Estimated Glomerular Filtration Rate in Indian Cirrhotic Patients: Report of a Pilot Study.
J Clin Exp Hepatol
November 2024
Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Background: Renal impairment significantly affects morbidity and mortality rates of cirrhosis patients. Studies on glomerular filtration rate (eGFR) estimation did not include cirrhosis patients. These equations are erroneous and unreliable in cirrhosis due to sarcopenia.
View Article and Find Full Text PDFAssociation of protein intake with discordance between cystatin C- and creatinine-based eGFR in community-dwelling Japanese adults.
J Ren Nutr
January 2025
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Maryland, USA.
Article Synopsis
- Recent research highlights the prognostic significance of differences between creatinine-based and cystatin C-based estimated glomerular filtration rates (eGFR) but lacks focus on the impact of protein intake on these differences.
- The study analyzed data from over 6,000 participants in Japan to explore the relationship between dietary protein consumption and eGFR discordance, evaluating results separately for men and women due to varying dietary patterns.
- Findings revealed that higher total protein intake, particularly from animal sources in men, was linked to increased eGFR discordance, suggesting that dietary factors should be considered in future research on eGFR-related health outcomes.
Effect of an intensive lifestyle intervention on cystatin C-based kidney function in adults with overweight and obesity: From the PREDIMED-Plus trial.
J Intern Med
February 2025
Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain.
Background: Large-scale trials evaluating a multicomponent lifestyle intervention aimed at weight loss on kidney function are lacking.
Methods: This was a post hoc analysis of the "PREvención con DIeta MEDiterránea-Plus" (PREDIMED-Plus) randomized controlled trial, including patients with overweight/obesity and metabolic syndrome, measured cystatin C and creatinine. Participants were randomly assigned (1:1) to an intensive weight loss lifestyle intervention (intervention group [IG]) consisting of an energy-restricted Mediterranean diet (MedDiet), physical activity promotion and behavioral support, or a control group (CG) receiving ad libitum MedDiet recommendations.
Plasma Biomarkers of Kidney Health and Mortality in Diabetes and Chronic Kidney Disease in the REGARDS Study.
Clin J Am Soc Nephrol
December 2024
Kidney Health Research Collaborative and Department of Medicine, University of.
Key Points: In diabetes and CKD, creatinine- and cystatin C–based eGFR has a strong inverse correlation with plasma TNF receptor 1, TNF receptor 2, and soluble urokinase-type plasminogen activator receptor. Higher plasma soluble TNF receptors 1 and 2 and soluble urokinase-type plasminogen activator receptor were each individually associated with mortality, independent of baseline kidney measures.
Background: Several plasma biomarkers of kidney health have been associated with CKD progression in persons with diabetes, but their associations with mortality risk have been largely unexplored.
Deterioration in Renal Function in Patients With a Fontan Circulation and Association With Mortality.
JACC Adv
December 2024
Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Article Synopsis
- Renal dysfunction is common in patients with Fontan circulation, with 12% showing renal issues based on eGFR measurements, and 24% based on cystatin C levels.
- Over an 11-year study, these patients experienced a faster decline in renal function compared to healthy individuals, averaging a drop of 1.36 ml/min/1.73 m/year.
- Higher levels of NT-proBNP at the start were linked to quicker drops in renal function, and worsened renal function over time was associated with increased mortality rates.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!