Background: The recent guidelines recommend using the estimated glomerular filtration rate (eGFR) to evaluate renal function. There are two reported full-age-spectrum (FAS) equations in 2017, which are based on serum cystatin C concentrations with or without accompanying serum creatinine level (FAS or FAS). We compared the performance and assessed the applicability of the new FAS equation with the 2012 CKD-EPI (CKD-EPI and CKD-EPI) equation in Chinese subjects.

Methods: A total of 1184 patients, mean aged 55.06 year who underwent Tc-DTPA GFR measurements (rGFR) from four hospitals were enrolled. The bias (eGFR-rGFR), precision (interquartile range of difference [IQR]), and accuracy (the proportion of eGFR within 30% of rGFR [P30]) of eGFR and rGFR calculated by four equations were compared.

Results: Generally, the equation based on the combination of Cys and Scr performed superior to that on the basis of Cys alone, either the CKD-EPI or the FAS. Detailedly, referred to rGFR (67.33 ml/min/1.73 m), the CKD-EPI, CKD-EPI, FAS, and the FAS estimated GFR 56.46 ml/min/1.73 m, 62.79 ml/min/1.73 m, 56.45 ml/min/1.73 m, and 61.04 ml/min/1.73 m, gave ROC0.944, 0.954, 0.943, and 0.953, respectively. Another comparison as to bias, precision, P, and RMSE with FAS were - 2.87 ml/min/1.73 m, 19.01 ml/min/1.73 m, 74.16%, and 17.84 ml/min/1.73 m showed that FAS performed approximately more accurate than other equations, as well as the diagnostic consistency of GFR staging. In the rGFR < 60 ml/min/1.73 m subgroup, the FAS equation showed the best performance. In older subjects, compared with FAS, CKD-EPI, and CKD-EPI, the FAS equation had relatively less bias (- 8.09 vs. - 9.63, - 7.52, - 11.04, P < 0.05), most precise (15.18 vs. 16.32, 15.22, 16.63), and most accuracy, P was statistically different from the other equations, and achieved a ideal value > 70%.

Conclusion: The performance of the FAS equation is better than that of the CKD-EPI equation in the Chinese population, particularly in the elderly. Yet, further modification of FAS equations from a large-scale study could be more suitable for the Chinese population, particularly in older people.

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Source
http://dx.doi.org/10.1007/s11255-018-1997-4DOI Listing

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