Comparison of Cystatin C and Creatinine-based Glomerular Filtration Rate Formulas with 51Cr-EDTA Clearance in Patients with Cirrhosis

Clinical journal of the American Society of Nephrology : CJASN - Tập 6 Số 1 - Trang 84-92 - 2011
Elias Xirouchakis1, Laura Marelli1, Εvangelos Cholongitas1, Pinelopi Manousou1, Vincenza Calvaruso1, M. Pleguezuelo1, Gian Piero Guerrini1, S. Maimone1, Andrew Kerry2, Mark Hajjawi2, Devaki Nair2, Michael Thomas2, David Patch1, Andrew K. Burroughs3,4,5,1
1Royal Free Sheila Sherlock Liver Centre and the University Department of Surgery and
2Department of Clinical Biochemistry, Royal Free Hospital and University College London, London, United Kingdom
3Dr. Andrew K. Burroughs, The Royal Free Sheila Sherlock Liver Centre, and Department of Surgery, Royal Free Hospital, Pond Street, Hampstead, London NW3 2QG, UK. Phone: 44-20-74726229
4e-mail: [email protected]
5Fax: 44-20-74726226

Tóm tắt

Summary Background and objectives Renal function is an important predictor of survival in cirrhosis and liver transplantation. GFR estimates using serum cystatin C (CysC) are proposed as better predictors of renal function than ones on the basis of serum creatinine (Cr). Our aims were: (1) evaluate correlations between serum CysC and different methods of creatinine measurements; (2) compare CysC and Cr GFR formulas with 51Cr-EDTA; and (3) evaluate liver-related parameters potentially influencing GFR. Design, setting, participants, & measurements 254 blood samples in 65 patients with cirrhosis correlating CysC with four Cr methods were used; another 74 patients comparing 51Cr-EDTA GFR to Modification of Diet in Renal Disease and Larsson and Hoek formulas for CysC were also included. Agreement was assessed using Bland-Altman plots and concordance correlation coefficients. Multivariate linear regression analysis was used for GFR predictors. Results Serum CysC correlated modestly with O'Leary modified Jaffe, compensated kinetic Jaffe, enzymatic creatinine, and standard kinetic Jaffe 0.72/0.71/0.72/0.72 (all P < 0.001). Bland-Altman agreement with 51Cr-EDTA GFR was poor; the best agreement was Modification of Diet in Renal Disease (concordance 0.61; 95% CI, 0.47 to 0.71); the worst agreement was the Hoek formula (concordance 0.46; 95% CI, 0.27 to 0.61). A new GFR formula including the Child-Pugh score improved the accuracy of Cr GFR formulas compared with 51Cr-EDTA GFR. Conclusions Estimated GFR in cirrhosis is not better with CysC formulas compared with creatinine ones: specific formulas may be necessary.

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Tài liệu tham khảo

Terra, 2005, Renal failure in patients with cirrhosis and sepsis unrelated to spontaneous bacterial peritonitis: Value of MELD score, Gastroenterology, 129, 1944, 10.1053/j.gastro.2005.09.024

Gonwa, 2006, Continued influence of preoperative renal function on outcome of orthotopic liver transplant (OLTX) in the US: Where will MELD lead us?, Am J Transplant, 6, 2651, 10.1111/j.1600-6143.2006.01526.x

Seronie-Vivien, 2005, Impact of standardized calibration on the inter-assay variation of 14 automated assays for the measurement of creatinine in human serum, Clin Chem Lab Med, 43, 1227, 10.1515/CCLM.2005.213

Cholongitas, 2007, Different methods of creatinine measurement significantly affect MELD scores, Liver Transpl, 13, 523, 10.1002/lt.20994

Trotter, 2004, Specific laboratory methodologies achieve higher model for endstage liver disease (MELD) scores for patients listed for liver transplantation, Liver Transpl, 10, 995, 10.1002/lt.20195

Goulding, 2010, Assessment of reproducibility of creatinine measurement and MELD scoring in four liver transplant units in the UK, Nephrol Dial Transplant, 25, 960, 10.1093/ndt/gfp556

Cholongitas, 2007, Female liver transplant recipients with the same GFR as male recipients have lower MELD scores: A systematic bias, Am J Transplant, 7, 685, 10.1111/j.1600-6143.2007.01666.x

Cockcroft, 1976, Prediction of creatinine clearance from serum creatinine, Nephron, 16, 31, 10.1159/000180580

Levey, 1999, A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation, Ann Intern Med, 130, 461, 10.7326/0003-4819-130-6-199903160-00002

Gonwa, 2004, Estimation of glomerular filtration rates before and after orthotopic liver transplantation: Evaluation of current equations, Liver Transpl, 10, 301, 10.1002/lt.20017

Lamb, 2005, Estimating kidney function in adults using formulas, Ann Clin Biochem, 42, 321, 10.1258/0004563054889936

Newman, 2002, Cystatin C, Ann Clin Biochem, 39, 89, 10.1258/0004563021901847

Filler, 2005, Cystatin C as a marker of GFR–history, indications, and future research, Clin Biochem, 38, 1, 10.1016/j.clinbiochem.2004.09.025

Zahran, 2007, Can cystatin C replace creatinine to estimate glomerular filtration rate? A literature review, Am J Nephrol, 27, 197, 10.1159/000100907

Woitas, 2000, Correlation of serum concentrations of cystatin C and creatinine to inulin clearance in liver cirrhosis, Clin Chem, 46, 712, 10.1093/clinchem/46.5.712

Orlando, 2002, Diagnostic value of plasma cystatin C as a glomerular filtration marker in decompensated liver cirrhosis, Clin Chem, 48, 850, 10.1093/clinchem/48.6.850

Ustundag, 2007, Analysis of glomerular filtration rate, serum cystatin C levels, and renal resistive index values in cirrhosis patients, Clin Chem Lab Med, 45, 890, 10.1515/CCLM.2007.130

Grubb, 2005, Simple cystatin C-based prediction equations for glomerular filtration rate compared with the Modification of Diet in Renal Disease prediction equation for adults and the Schwartz and the Counahan-Barratt prediction equations for children, Clin Chem, 51, 1420, 10.1373/clinchem.2005.051557

Poge, 2006, Calculation of glomerular filtration rate based on cystatin C in cirrhotic patients, Nephrol Dial Transplant, 21, 660, 10.1093/ndt/gfi305

Larsson, 2004, Calculation of glomerular filtration rate expressed in mL/min from plasma cystatin C values in mg/L, Scand J Clin Lab Invest, 64, 25, 10.1080/00365510410003723

Hoek, 2003, A comparison between cystatin C, plasma creatinine and the Cockcroft and Gault formula for the estimation of glomerular filtration rate, Nephrol Dial Transplant, 18, 2024, 10.1093/ndt/gfg349

Takeuchi, 2001, Elevation of serum cystatin C concentrations in patients with chronic liver disease, Eur J Gastroenterol Hepatol, 13, 951, 10.1097/00042737-200108000-00013

Chu, 2004, Increased cystatin C serum concentrations in patients with hepatic diseases of various severities, Clin Chim Acta, 341, 133, 10.1016/j.cccn.2003.11.011

Chen, 2005, Relationship between matrix metalloproteinase-2 activity and cystatin C levels in patients with hepatic disease, Clin Biochem, 38, 632, 10.1016/j.clinbiochem.2005.03.005

Pugh, 1973, Transection of Esophagus for Bleeding Esophageal Varices, Br J Surg, 60, 646, 10.1002/bjs.1800600817

Miller, 2005, Creatinine measurement: state of the art in accuracy and interlaboratory harmonization, Arch Pathol Lab Med, 129, 297, 10.5858/2005-129-297-CMSOTA

Fleming, 2004, The new BNMS guidelines for measurement of glomerular filtration rate, Nucl Med Commun, 25, 755, 10.1097/01.mnm.0000136714.77658.4a

Poggio, 2005, Performance of the Cockcroft-Gault and Modification of Diet in Renal Disease equations in estimating GFR in ill hospitalized patients, Am J Kidney Dis, 46, 242, 10.1053/j.ajkd.2005.04.023

Bland, 1986, Statistical methods for assessing agreement between two methods of clinical measurement, Lancet, 1, 307, 10.1016/S0140-6736(86)90837-8

Liao, 2000, A note on concordance correlation coefficient, PDA J Pharmaceutical Sci Tech, 54, 23

Gerbes, 2002, Evaluation of serum cystatin C concentration as a marker of renal function in patients with cirrhosis of the liver, Gut, 50, 106, 10.1136/gut.50.1.106

Newman, 1995, Serum cystatin-C measured by automated immunoassay: A more sensitive marker of changes in GFR than serum creatinine, Kidney Int, 47, 312, 10.1038/ki.1995.40

Kuan, 2005, GFR prediction using the MDRD and Cockcroft and Gault equations in patients with end-stage renal disease, Nephrol Dial Transplant, 20, 2394, 10.1093/ndt/gfi076

Cardenas, 2001, Renal failure after upper gastrointestinal bleeding in cirrhosis: Incidence, clinical course, predictive factors, and short-term prognosis, Hepatology, 34, 671, 10.1053/jhep.2001.27830

Fraley, 1998, Impact of acute renal failure on mortality in end-stage liver disease with or without transplantation, Kidney Int, 54, 518, 10.1046/j.1523-1755.1998.00004.x

Baliga, 1992, Preoperative risk factor assessment in liver transplantation, Surgery, 112, 704

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Thông tin xuất bản

Clinical journal of the American Society of Nephrology : CJASN

Tập 6 Số 1

84-92

Thông tin tác giả