Elisa Diego1, Pedro Castro2, Dolors Soy1, Esteban Poch3, Josep M Nicolás4. 1. Pharmacy Department, Hospital Clinic of Barcelona, Institut D'Investigacions Biomediques August Pi I Sunyer, University of Barcelona, Barcelona, Spain. 2. Medical Intensive Care Unit, Hospital Clinic of Barcelona, Institut D'Investigacions Biomediques August Pi I Sunyer, University of Barcelona, Barcelona, Spain. pcastro@clinic.ub.es. 3. Nephrology and Transplantation Department, Hospital Clinic of Barcelona, Institut D'Investigacions Biomediques August Pi I Sunyer, University of Barcelona, Barcelona, Spain. 4. Medical Intensive Care Unit, Hospital Clinic of Barcelona, Institut D'Investigacions Biomediques August Pi I Sunyer, University of Barcelona, Barcelona, Spain.
Abstract
PURPOSE: The predictive performance of glomerular filtration rate (GFR) estimation equations based on cystatin C versus serum creatinine (SCr) values in critically ill patients was evaluated. METHODS: A retrospective observational study was performed in the medical intensive care unit (ICU) of a university hospital from October 2006 through September 2007. All consecutively admitted critically ill patients older than 18 years who stayed in the ICU for more than 48 hours with a urinary bladder catheter in place were included in the study. Data collected included SCr, cystatin C, serum albumin, blood urea nitrogen, and 24-hour urine creatinine clearance [Formula: see text] levels. The following equations were also used to determine the estimated GFR that was compared with the reference [Formula: see text] for all patients in the study: Arnal-Dade using cystatin C, Cockcroft-Gault using actual body weight, Cockcroft-Gault using ideal body weight, Jelliffe, Modification of Diet in Renal Disease (MDRD), and four-variable version MDRD (MDRD-4). RESULTS: This study included 241 measurements corresponding to 131 critically ill patients. The cystatin C-based equation underestimated [Formula: see text], whereas overestimation by every SCr-based formula was observed in the whole cohort and in the [Formula: see text] subgroup; MDRD-4 was the most biased equation in every analysis. There were no significant differences in precision, except for great variability in the subgroup with a [Formula: see text] of <60 mL/min/1.73 m(2), where the MDRD equation showed better results than the cystatin C-based equation (33.5% versus 38.9%). No equations fulfilled concordance requirements with [Formula: see text]. CONCLUSION: A retrospective observational study showed no evidence of superiority of a cystatin C-based equation over SCr-based equations to estimate the GFR in an ICU population.
PURPOSE: The predictive performance of glomerular filtration rate (GFR) estimation equations based on cystatin C versus serum creatinine (SCr) values in critically illpatients was evaluated. METHODS: A retrospective observational study was performed in the medical intensive care unit (ICU) of a university hospital from October 2006 through September 2007. All consecutively admitted critically illpatients older than 18 years who stayed in the ICU for more than 48 hours with a urinary bladder catheter in place were included in the study. Data collected included SCr, cystatin C, serum albumin, blood ureanitrogen, and 24-hour urine creatinine clearance [Formula: see text] levels. The following equations were also used to determine the estimated GFR that was compared with the reference [Formula: see text] for all patients in the study: Arnal-Dade using cystatin C, Cockcroft-Gault using actual body weight, Cockcroft-Gault using ideal body weight, Jelliffe, Modification of Diet in Renal Disease (MDRD), and four-variable version MDRD (MDRD-4). RESULTS: This study included 241 measurements corresponding to 131 critically illpatients. The cystatin C-based equation underestimated [Formula: see text], whereas overestimation by every SCr-based formula was observed in the whole cohort and in the [Formula: see text] subgroup; MDRD-4 was the most biased equation in every analysis. There were no significant differences in precision, except for great variability in the subgroup with a [Formula: see text] of <60 mL/min/1.73 m(2), where the MDRD equation showed better results than the cystatin C-based equation (33.5% versus 38.9%). No equations fulfilled concordance requirements with [Formula: see text]. CONCLUSION: A retrospective observational study showed no evidence of superiority of a cystatin C-based equation over SCr-based equations to estimate the GFR in an ICU population.
Authors: Christian Nusshag; Markus A Weigand; Martin Zeier; Christian Morath; Thorsten Brenner Journal: Int J Mol Sci Date: 2017-06-28 Impact factor: 5.923
Authors: Azrina Md Ralib; Farah Nadia Mohd Hanafiah; Iqbalmunawwir Abd Rashid; Mohamad Shahrir Abd Rahim; Fatimah Dzaharudin; Mohd Basri Mat Nor Journal: Int J Nephrol Date: 2021-09-08