Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society · 2008
GFR estimates using cystatin C are superior to serum creatinine in adult patients with cystic fibrosis.
Сравнительное исследованиеСтатьяРандомизированное исследованиеПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Beringer Paul M, Hidayat Levita, Heed Anna, Zheng Ling, Owens Heather, Benitez Debbie, Rao Adupa P
Аннотация
BACKGROUND: Accurate assessment of renal function in patients with cystic fibrosis (CF) is vital for determining the appropriate dose of medications and for early detection of renal disease. Cystatin C (CysC) is a new marker of GFR with reportedly improved accuracy and precision compared to methods incorporating serum creatinine. The purpose of this study is to evaluate the predictive performance of cystatin C in estimating GFR in adult patients with CF.
METHODS: Iothalamate was administered to enable measurement of GFR in 38 adult patients with CF and control subjects. Creatinine clearance (C&G) and GFR estimates (cystatin C clearance [Cys C] and abbreviated modified diet in renal disease [aMDRD]) were compared using Bland-Altman and receiver operating characteristic (ROC) analysis. GFR cutoff values of 80 and 90 mL/min-1.73 m(2) were used in the analysis.
RESULTS: The measured GFR was similar in both the CF and healthy volunteers 104 (32.2) and 105 (29.9), P=0.969 respectively. No significant difference in mean bias was noted between the predictive methods within the CF population. Cys C provided the most precise estimates of GFR in both populations. ROC curves demonstrated that CysC provided greater sensitivity and specificity compared to the aMDRD (AUC 0.93 vs. 0.54, P=0.003) and C&G (AUC 0.93 vs. 0.56, P=0.005) in CF at a cutoff GFR of 90 mL/min-1.73 m(2).
CONCLUSION: Cystatin C clearance provides an improved marker of glomerular filtration rate in CF patients.
METHODS: Iothalamate was administered to enable measurement of GFR in 38 adult patients with CF and control subjects. Creatinine clearance (C&G) and GFR estimates (cystatin C clearance [Cys C] and abbreviated modified diet in renal disease [aMDRD]) were compared using Bland-Altman and receiver operating characteristic (ROC) analysis. GFR cutoff values of 80 and 90 mL/min-1.73 m(2) were used in the analysis.
RESULTS: The measured GFR was similar in both the CF and healthy volunteers 104 (32.2) and 105 (29.9), P=0.969 respectively. No significant difference in mean bias was noted between the predictive methods within the CF population. Cys C provided the most precise estimates of GFR in both populations. ROC curves demonstrated that CysC provided greater sensitivity and specificity compared to the aMDRD (AUC 0.93 vs. 0.54, P=0.003) and C&G (AUC 0.93 vs. 0.56, P=0.005) in CF at a cutoff GFR of 90 mL/min-1.73 m(2).
CONCLUSION: Cystatin C clearance provides an improved marker of glomerular filtration rate in CF patients.