Predictive performance of different kidney function estimation equations in lung transplant patients

Dov A. Degen, Jyotsna Janardan, Katherine A. Barraclough, Hans G. Schneider, Thomas Barber, Howard Barton, Gregory Snell, Bronwyn Levvey, Rowan G. Walker

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Background There has been limited examination of the performance of glomerular filtration rate estimation (eGFR) equations in lung transplant populations. This study aimed to compare the performance of serum creatinine and cystatin C based eGFR equations with Tc-99m diethylenetriaminepentaacetic acid (DTPA) GFR measurements in individuals with end-stage lung disease, either prior to, or following, lung transplantation. Methods In this prospective observational study, participants underwent GFR measurements with Tc-99m Pentetate. Measured results were compared with GFR estimates derived from estimation equations [4-variable Modification of Diet in Renal Disease, Cockcroft-Gault, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine, cystatin C and creatinine-cystatin C combined equations]. Results Ninety-seven individuals were studied (77 post- and 20 wait-listed for transplantation). Median (range) radionucleotide GFR was 56.7 ml/min/1.73 m2 (22.8–109.2 ml/min/1.73 m2). In the study cohort as a whole, the CKD-EPI creatinine-cystatin C combined equation showed the highest performance, but was only slightly superior to the CKD-EPI creatinine equation. However, in individuals with cystic fibrosis, low arm muscle mass and/or low body mass index, all of the creatinine-based equations showed unacceptable performance. In these subgroups, improved GFR estimation was seen with the CKD-EPI cystatin C equation, and predictions were better still using the CKD-EPI creatinine-cystatin C combined equation. Conclusions This study shows adequate predictive ability of CKD-EPI creatinine in the cohort as a whole, but unacceptable performance in patients with cystic fibrosis, low arm muscle mass and/or low body mass index. Our findings demonstrate that cystatin C may be a preferable filtration marker in these subgroups.

Original languageEnglish
Pages (from-to)385-393
Number of pages9
JournalClinical Biochemistry
Volume50
Issue number7-8
DOIs
Publication statusPublished - 1 May 2017

Cite this

@article{1dfaf7ad240e46f58bbb6aaf8d1d2321,
title = "Predictive performance of different kidney function estimation equations in lung transplant patients",
abstract = "Background There has been limited examination of the performance of glomerular filtration rate estimation (eGFR) equations in lung transplant populations. This study aimed to compare the performance of serum creatinine and cystatin C based eGFR equations with Tc-99m diethylenetriaminepentaacetic acid (DTPA) GFR measurements in individuals with end-stage lung disease, either prior to, or following, lung transplantation. Methods In this prospective observational study, participants underwent GFR measurements with Tc-99m Pentetate. Measured results were compared with GFR estimates derived from estimation equations [4-variable Modification of Diet in Renal Disease, Cockcroft-Gault, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine, cystatin C and creatinine-cystatin C combined equations]. Results Ninety-seven individuals were studied (77 post- and 20 wait-listed for transplantation). Median (range) radionucleotide GFR was 56.7 ml/min/1.73 m2 (22.8–109.2 ml/min/1.73 m2). In the study cohort as a whole, the CKD-EPI creatinine-cystatin C combined equation showed the highest performance, but was only slightly superior to the CKD-EPI creatinine equation. However, in individuals with cystic fibrosis, low arm muscle mass and/or low body mass index, all of the creatinine-based equations showed unacceptable performance. In these subgroups, improved GFR estimation was seen with the CKD-EPI cystatin C equation, and predictions were better still using the CKD-EPI creatinine-cystatin C combined equation. Conclusions This study shows adequate predictive ability of CKD-EPI creatinine in the cohort as a whole, but unacceptable performance in patients with cystic fibrosis, low arm muscle mass and/or low body mass index. Our findings demonstrate that cystatin C may be a preferable filtration marker in these subgroups.",
author = "Degen, {Dov A.} and Jyotsna Janardan and Barraclough, {Katherine A.} and Schneider, {Hans G.} and Thomas Barber and Howard Barton and Gregory Snell and Bronwyn Levvey and Walker, {Rowan G.}",
year = "2017",
month = "5",
day = "1",
doi = "10.1016/j.clinbiochem.2017.01.008",
language = "English",
volume = "50",
pages = "385--393",
journal = "Clinical Biochemistry",
issn = "0009-9120",
publisher = "Elsevier",
number = "7-8",

}

Predictive performance of different kidney function estimation equations in lung transplant patients. / Degen, Dov A.; Janardan, Jyotsna; Barraclough, Katherine A.; Schneider, Hans G.; Barber, Thomas; Barton, Howard; Snell, Gregory; Levvey, Bronwyn; Walker, Rowan G.

In: Clinical Biochemistry, Vol. 50, No. 7-8, 01.05.2017, p. 385-393.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Predictive performance of different kidney function estimation equations in lung transplant patients

AU - Degen, Dov A.

AU - Janardan, Jyotsna

AU - Barraclough, Katherine A.

AU - Schneider, Hans G.

AU - Barber, Thomas

AU - Barton, Howard

AU - Snell, Gregory

AU - Levvey, Bronwyn

AU - Walker, Rowan G.

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Background There has been limited examination of the performance of glomerular filtration rate estimation (eGFR) equations in lung transplant populations. This study aimed to compare the performance of serum creatinine and cystatin C based eGFR equations with Tc-99m diethylenetriaminepentaacetic acid (DTPA) GFR measurements in individuals with end-stage lung disease, either prior to, or following, lung transplantation. Methods In this prospective observational study, participants underwent GFR measurements with Tc-99m Pentetate. Measured results were compared with GFR estimates derived from estimation equations [4-variable Modification of Diet in Renal Disease, Cockcroft-Gault, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine, cystatin C and creatinine-cystatin C combined equations]. Results Ninety-seven individuals were studied (77 post- and 20 wait-listed for transplantation). Median (range) radionucleotide GFR was 56.7 ml/min/1.73 m2 (22.8–109.2 ml/min/1.73 m2). In the study cohort as a whole, the CKD-EPI creatinine-cystatin C combined equation showed the highest performance, but was only slightly superior to the CKD-EPI creatinine equation. However, in individuals with cystic fibrosis, low arm muscle mass and/or low body mass index, all of the creatinine-based equations showed unacceptable performance. In these subgroups, improved GFR estimation was seen with the CKD-EPI cystatin C equation, and predictions were better still using the CKD-EPI creatinine-cystatin C combined equation. Conclusions This study shows adequate predictive ability of CKD-EPI creatinine in the cohort as a whole, but unacceptable performance in patients with cystic fibrosis, low arm muscle mass and/or low body mass index. Our findings demonstrate that cystatin C may be a preferable filtration marker in these subgroups.

AB - Background There has been limited examination of the performance of glomerular filtration rate estimation (eGFR) equations in lung transplant populations. This study aimed to compare the performance of serum creatinine and cystatin C based eGFR equations with Tc-99m diethylenetriaminepentaacetic acid (DTPA) GFR measurements in individuals with end-stage lung disease, either prior to, or following, lung transplantation. Methods In this prospective observational study, participants underwent GFR measurements with Tc-99m Pentetate. Measured results were compared with GFR estimates derived from estimation equations [4-variable Modification of Diet in Renal Disease, Cockcroft-Gault, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine, cystatin C and creatinine-cystatin C combined equations]. Results Ninety-seven individuals were studied (77 post- and 20 wait-listed for transplantation). Median (range) radionucleotide GFR was 56.7 ml/min/1.73 m2 (22.8–109.2 ml/min/1.73 m2). In the study cohort as a whole, the CKD-EPI creatinine-cystatin C combined equation showed the highest performance, but was only slightly superior to the CKD-EPI creatinine equation. However, in individuals with cystic fibrosis, low arm muscle mass and/or low body mass index, all of the creatinine-based equations showed unacceptable performance. In these subgroups, improved GFR estimation was seen with the CKD-EPI cystatin C equation, and predictions were better still using the CKD-EPI creatinine-cystatin C combined equation. Conclusions This study shows adequate predictive ability of CKD-EPI creatinine in the cohort as a whole, but unacceptable performance in patients with cystic fibrosis, low arm muscle mass and/or low body mass index. Our findings demonstrate that cystatin C may be a preferable filtration marker in these subgroups.

UR - http://www.scopus.com/inward/record.url?scp=85010216508&partnerID=8YFLogxK

U2 - 10.1016/j.clinbiochem.2017.01.008

DO - 10.1016/j.clinbiochem.2017.01.008

M3 - Article

VL - 50

SP - 385

EP - 393

JO - Clinical Biochemistry

JF - Clinical Biochemistry

SN - 0009-9120

IS - 7-8

ER -