4CPS-016 Predictive performance of glomerular filtration rate equations based on cystatin c, creatinine and their combination in critically ill patients

• Published in: European journal of hospital pharmacy. Science and practice 2023-03, Vol.30 (Suppl 1), p.A29-A29
• Main Authors: Albanell, M, Bastida, C, Marcos-Fendian, Á, Escolà, A, Mercandal, J, Castro, P, Soy, D
• Format: Article
• Language: English
• Subjects: Bias; Conflicts of interest; Creatinine; Section 4: Clinical pharmacy services; Steroids; Thyroid gland
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2023-eahp.63

Background and ImportanceTwenty-four hour urine creatinine clearance (24h-ClCr) remains the gold-standard for estimating glomerular filtration rate (GFR) in critically ill patients; however, it has several drawbacks. Serum creatinine (SCr) is the most frequently used parameter to estimate GFR, however, Cystatin-C (CystC) may reflect GFR changes earlier than SCr.Aim and ObjectivesTo assess the performance of equations based on SCr, CystC, and their combination (SCr-CystC) for estimating GFR in critically ill patients in comparison to 24h-ClCr.Material and MethodsRetrospective, observational study in a tertiary-care hospital (May 2020 to July 2022). Patients with CystC, SCr and 24h-ClCr measurements within ± 2 days were included. Altered thyroid status and corticosteroids use for >5 days were recorded, as both can alter CystC values.24h-ClCr was considered the reference method. GFR was estimated using SCr-based equations: CKD-EPI-Cr and Cockcroft-Gault (CG); CystC-based equations: CKD-EPI-CystC and CAPA; and Cr-CystC-based equations: CKD-EPI-Cr-CystC.Bland-Altman plots were used to compare GFR estimations with 24h-ClCr. Pearson´s correlation coefficients and concordance correlation coefficients (CCC) were calculated. Bias was assessed as (estimated GFR – 24h-ClCr); and precision as the SD of bias. Further analysis was performed with stratified data into 24h-CrCl