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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+J+Am+Soc+Nephrol
2016 ; 11
(9
): 1640-1649
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Creatinine-Based and Cystatin C-Based GFR Estimating Equations and Their Non-GFR
Determinants in Kidney Transplant Recipients
#MMPMID27340283
Keddis MT
; Amer H
; Voskoboev N
; Kremers WK
; Rule AD
; Lieske JC
Clin J Am Soc Nephrol
2016[Sep]; 11
(9
): 1640-1649
PMID27340283
show ga
BACKGROUND AND OBJECTIVES: eGFR equations have been evaluated in kidney
transplant recipients with variable performance. We assessed the performance of
the Modification of Diet in Renal Disease equation and the Chronic Kidney Disease
Epidemiology Collaboration equations on the basis of creatinine, cystatin C, and
both (eGFR creatinine-cystatin C) compared with measured GFR by iothalamate
clearance and evaluated their non-GFR determinants and associations across 15
cardiovascular risk factors. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A
cross-sectional cohort of 1139 kidney transplant recipients >1 year after
transplant was analyzed. eGFR bias, precision, and accuracy (percentage of
estimates within 30% of measured GFR) were assessed. Interaction of each
cardiovascular risk factor with eGFR relative to measured GFR was determined.
RESULTS: Median measured GFR was 55.0 ml/min per 1.73 m(2). eGFR creatinine
overestimated measured GFR by 3.1% (percentage of estimates within 30% of
measured GFR of 80.4%), and eGFR Modification of Diet in Renal Disease
underestimated measured GFR by 2.2% (percentage of estimates within 30% of
measured GFR of 80.4%). eGFR cystatin C underestimated measured GFR by -13.7%
(percentage of estimates within 30% of measured GFR of 77.1%), and eGFR
creatinine-cystatin C underestimated measured GFR by -8.1% (percentage of
estimates within 30% of measured GFR of 86.5%). Lower measured GFR associated
with older age, women, obesity, longer time after transplant, lower HDL, lower
hemoglobin, lower albumin, higher triglycerides, higher proteinuria, and an
elevated cardiac troponin T level but did not associate with diabetes, smoking,
cardiovascular events, pretransplant dialysis, or hemoglobin A1c. These risk
factor associations differed for five risk factors with eGFR creatinine, six risk
factors for eGFR Modification of Diet in Renal Disease, ten risk factors for eGFR
cystatin C, and four risk factors for eGFR creatinine-cystatin C. CONCLUSIONS:
Thus, eGFR creatinine and eGFR creatinine-cystatin C are preferred over eGFR
cystatin C in kidney transplant recipients because they are less biased, more
accurate, and more consistently reflect the same risk factor associations seen
with measured GFR.