[Clinical comparison study of Chinese adult serum cystatin C based estimated glomerular filtration rate equations].

Abstract

Objective: To probe the clinical value of estimated glomerular filtration rate (GFR) formulas for adults Chinese based on the serum cystatin C(SCys C, SCysCAC).

Methods: GFRs for 96 cases of patient in hospital suffering from the kidney diseases without dialysis from January to December in 2011 were measured using clearance rate of (99m) Tc-diethylene triamine pentaacetic acid ((99m) Tc- DTPA, Tc-GFR) by prospective control study method. Based on the renal function, 96 patients were sorted into renal function insufficient group (RFI, n=54) and renal function normal group (RFN, n=42). The SCys C, serum creatinine (SCr) and blood urea nitrogen (BUN) were measured at the same day for calculating GFRs simultaneously by nine formulas such as SCysCAC, Arnal-Dade, Grubb, Filler, Grubb, Hojs, Larsson, Macisaac, Rule etc. The comparison were performed for the estimated GFRs (eGFRs) of renal insufficiency patients and those with normal renal function and the correlation analysis were done between the calculations and Tc-GFR respectively.

Results: eGFRs calculated by SCysCAC, Arnal-Dade, Larsson and Rule formulae always were close to those of Tc-GFR and that were 37.96±32.65 ml×min(-1)×1.73 m(-2), 33.69±25.24 ml×min(-1)×1.73 m(-2), 34.16±33.65 ml×min(-1)×1.73 m(-2), 33.02±30.88 ml×min(-1)×1.73 m(-2) vs. 36.21±31.16 ml×min(-1)×1.73 m(-2) in RFI group, 112.99±39.26 ml×min(-1)×1.73 m(-2), 101.86±72.29 ml×min(-1)×1.73 m(-2), 102.69±71.78 ml×min(-1)×1.73 m(-2), 99.12±69.54 ml×min(-1)×1.73 m(-2) vs. 110.54±48.98 ml×min(-1)×1.73 m(-2) in RFN group (all P>0.05). The absolute value difference between eGFR by SCysCAC, Larsson and Arnal-Dade formulae and Tc-GFR in RFN or RFI group showed no significant change and the absolute value of the value difference between SCysCAC-eGFR and Tc-GFR was the least among the three absolute values and showed that eGFRs from the three formulas could all reflect the GFR accurately and the SCysCAC formula was the best. The correlation analysis showed the eGFRs from every formula could all to some extent reflect the glomerular function or GFR accurately.

Conclusion: The SCysCAC formula was a quickly and accurate method for estimating GFR and may apply clinically.