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Abstract: ASN Annual Meeting -- San Francisco |
Maillard N, Mariat C, Alamartine E, et al.
Cystatin C-Based Equations in Renal Transplantation: Moving toward a Better GFR Prediction?
ASN Annual Meeting -- San Francisco
J Am Soc Nephrol (Nov) 18:689A 2007
Creatinine-based glomerular filtration rate (GFR) estimators perform poorly in renal transplant recipients. Cystatin C is an endogenous peptide which is freely and exclusively filtered by the glomerulus, and thus might replace creatinine to assess renal graft function.
The aim of this study was to evaluate several cystatin C-based equations in kidney transplantation. We compared the performance of the Hoek, Larrson, Filler, LeBricon and Rule equations to the MDRD equation in 62 adult renal transplant recipients for whom the GFR was measured by the gold standard inulin clearance. Serum creatinine and cystatin C were measured the day of the inulin clearance by immunonephelometric and enzymatic method, respectively. Bias, precision, accuracy 30% (Acc-30) and sensitivity were determined for each of the GFR equations.
Mean inulin-measured GFR was 52,6 ml/min/1,73m[range, 13-119]. Overall, cystatin C based estimators tend to give a better prediction (Acc-30 ranging from 68 to 85 %) than the MDRD equation (Acc-30, 64%). The Hoek equation was significantly more accurate than the MDRD equation with 95% confidence interval (95%CI) for Acc-30 of [77;94] and [53;76], respectively. Among the different cystatin C equations, the Hoek, Larrson and Rule equations displayed the best predictive performance. Likewise, sensitivity to detect a GFR below 60 ml/min/1,73m
In conclusion, the Hoek, Larsson and Rule cystatin C equations show a better performance in predicting inulin-measured GFR in kidney transplantation as compared to the MDRD equation. Our data suggest that cystatin C as a GFR marker, might offer significant advantages over creatinine in renal transplantation.The poster for this abstract is available for viewing. YOU MUST SIGN IN FIRST at the ASN Posters2View website: (you need to type in a separate username and password of your choosing). If you are not signed in, the direct link to the poster below will not work!
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