Comparing the Accuracy of Standard Equations to Predict Glomerular Filtration Rate for Persons with Spinal Cord Injury: Which Is the "Best Fit?"

IF 2.4 Q1 REHABILITATION
Topics in Spinal Cord Injury Rehabilitation Pub Date : 2024-01-01 Epub Date: 2024-11-28 DOI:10.46292/sci24-00001
Nicholas Brown, Kathryn Struck, Terry Romo, Wouter Koek, Ashley Everett Garcia, Mark Fredrickson, Michelle Trbovich
{"title":"Comparing the Accuracy of Standard Equations to Predict Glomerular Filtration Rate for Persons with Spinal Cord Injury: Which Is the \"Best Fit?\"","authors":"Nicholas Brown, Kathryn Struck, Terry Romo, Wouter Koek, Ashley Everett Garcia, Mark Fredrickson, Michelle Trbovich","doi":"10.46292/sci24-00001","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Patients with spinal cord injury (SCI) are at increased risk of renal insufficiency, so their renal function must regularly be monitored. Glomerular filtration rate (GFR) assessment is challenging as it requires measuring clearance of exogenous markers, which is impractical in most clinical settings. Thus, equations have been formulated to estimate GFR that utilize serum creatinine (Cr) or cystatin C (CysC).</p><p><strong>Objectives: </strong>Given loss of muscle mass after SCI, we hypothesized equations using CysC would be more accurate than those using Cr after SCI.</p><p><strong>Methods: </strong>Fifty-eight persons (51 male/7 female; age 22-87 years) with SCI level C2-L1/AIS A-D were enrolled. Serum CysC and Cr, 24-hour urine creatinine (24hrUCr) and 24-hour urine urea (24hrUurea) were collected. Average of the 24hrUCr clearance and 24hrUurea clearance was calculated (AvgCl<sub>CrUr</sub>). Six GFR estimating equations were compared to AvgCl<sub>CrUr</sub>. For each equation, mean bias (AvgCl<sub>CrUr</sub> - eGFR) was calculated followed by the Pearson correlation calculation between AvgCl<sub>CrUr</sub> and eGFR. In addition, the percentage of estimated values within 15%, 30%, and 50% of AvgCl<sub>CrUr</sub> values are reported for each estimating equation.</p><p><strong>Results: </strong>2012 CKD-EPI CysC equation (bias 9.32 mg/dL, 95% CI, -1.23 to -17.41) was the most accurate predictor of GFR. This model accurately predicted GFR of 81%, 57%, and 33% within ±50%, ±30%, and ±15% of the AvgCl<sub>CrUr</sub>, respectively. <b>Conclusion</b>: In persons with SCI, the CKD-EPI 2012 CysC equation, which uses cystatin C rather than creatinine, is the most accurate of the six equations tested in estimating GFR in persons with SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"30 4","pages":"57-65"},"PeriodicalIF":2.4000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603108/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Topics in Spinal Cord Injury Rehabilitation","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.46292/sci24-00001","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/28 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Patients with spinal cord injury (SCI) are at increased risk of renal insufficiency, so their renal function must regularly be monitored. Glomerular filtration rate (GFR) assessment is challenging as it requires measuring clearance of exogenous markers, which is impractical in most clinical settings. Thus, equations have been formulated to estimate GFR that utilize serum creatinine (Cr) or cystatin C (CysC).

Objectives: Given loss of muscle mass after SCI, we hypothesized equations using CysC would be more accurate than those using Cr after SCI.

Methods: Fifty-eight persons (51 male/7 female; age 22-87 years) with SCI level C2-L1/AIS A-D were enrolled. Serum CysC and Cr, 24-hour urine creatinine (24hrUCr) and 24-hour urine urea (24hrUurea) were collected. Average of the 24hrUCr clearance and 24hrUurea clearance was calculated (AvgClCrUr). Six GFR estimating equations were compared to AvgClCrUr. For each equation, mean bias (AvgClCrUr - eGFR) was calculated followed by the Pearson correlation calculation between AvgClCrUr and eGFR. In addition, the percentage of estimated values within 15%, 30%, and 50% of AvgClCrUr values are reported for each estimating equation.

Results: 2012 CKD-EPI CysC equation (bias 9.32 mg/dL, 95% CI, -1.23 to -17.41) was the most accurate predictor of GFR. This model accurately predicted GFR of 81%, 57%, and 33% within ±50%, ±30%, and ±15% of the AvgClCrUr, respectively. Conclusion: In persons with SCI, the CKD-EPI 2012 CysC equation, which uses cystatin C rather than creatinine, is the most accurate of the six equations tested in estimating GFR in persons with SCI.

求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
3.20
自引率
3.40%
发文量
33
期刊介绍: Now in our 22nd year as the leading interdisciplinary journal of SCI rehabilitation techniques and care. TSCIR is peer-reviewed, practical, and features one key topic per issue. Published topics include: mobility, sexuality, genitourinary, functional assessment, skin care, psychosocial, high tetraplegia, physical activity, pediatric, FES, sci/tbi, electronic medicine, orthotics, secondary conditions, research, aging, legal issues, women & sci, pain, environmental effects, life care planning
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信