OBJECTIVES: Comparison of the effect of corticosteroid therapy on the diagnostic performance of cystatin C (Cys) and beta-trace protein (bTP), two endogenous markers of GFR. DESIGN AND METHODS: Out of a total of 193 pediatric inulin clearance studies, a random sample of 85 steroid-free studies served to establish GFR prediction equations (eGFR), which were used to compare the remaining 76 steroid-free and 32 steroid-positive studies (median prednisone dose 33.0 mg m(-2) day(-1)). RESULTS: We found a positive relationship between prednisone dose and eGFR(betaTP) (b=0.414, p=0.0002) and a negative relationship with eGFR(cys) (b=-0.208, p=0.0091). Only Cys independently predicted GFR below 90 mL min(-1) 1.73 m(-2), both in steroid-positives (b=6.260, p=0.010) and steroid-negatives (b=6.845, p=0.012). Glucocorticoid therapy did not affect the accuracy in estimating GFR within 30% of measured GFR for Cys, while accuracy was lower with bTP (65.6% vs. 81.6%, p=0.08). CONCLUSION: Glucocorticoids have less impact on the diagnostic accuracy of Cys than bTP.
OBJECTIVES: Comparison of the effect of corticosteroid therapy on the diagnostic performance of cystatin C (Cys) and beta-trace protein (bTP), two endogenous markers of GFR. DESIGN AND METHODS: Out of a total of 193 pediatric inulin clearance studies, a random sample of 85 steroid-free studies served to establish GFR prediction equations (eGFR), which were used to compare the remaining 76 steroid-free and 32 steroid-positive studies (median prednisone dose 33.0 mg m(-2) day(-1)). RESULTS: We found a positive relationship between prednisone dose and eGFR(betaTP) (b=0.414, p=0.0002) and a negative relationship with eGFR(cys) (b=-0.208, p=0.0091). Only Cys independently predicted GFR below 90 mL min(-1) 1.73 m(-2), both in steroid-positives (b=6.260, p=0.010) and steroid-negatives (b=6.845, p=0.012). Glucocorticoid therapy did not affect the accuracy in estimating GFR within 30% of measured GFR for Cys, while accuracy was lower with bTP (65.6% vs. 81.6%, p=0.08). CONCLUSION: Glucocorticoids have less impact on the diagnostic accuracy of Cys than bTP.
Authors: Tariq Shafi; Wieneke M Michels; Andrew S Levey; Lesley A Inker; Friedo W Dekker; Raymond T Krediet; Tiny Hoekstra; George J Schwartz; John H Eckfeldt; Josef Coresh Journal: Kidney Int Date: 2016-01-21 Impact factor: 10.612
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Authors: Emil den Bakker; Reinoud Gemke; Joanna A E van Wijk; Isabelle Hubeek; Birgit Stoffel-Wagner; Arend Bökenkamp Journal: Pediatr Nephrol Date: 2018-05-17 Impact factor: 3.714