Predictive performance of glomerular filtration rate estimation equations based on cystatin C versus serum creatinine values in critically ill patients

PURPOSEThe predictive performance of glomerular filtration rate (GFR) estimation equations based on cystatin C versus serum creatinine (SCr) values in critically ill patients was evaluated. METHODSA retrospective observational study was performed in the medical intensive care unit (ICU) of a univers...

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Bibliographic Details
Published in:American journal of health-system pharmacy 2016-02, Vol.73 (4), p.206-215
Main Authors: Diego, Elisa, Castro, Pedro, Soy, Dolors, Poch, Esteban, Nicolás, Josep M
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Comparative analysis
Creatinine
Creatinine - blood
Creatinine - urine
Critical Illness
Critically ill
Cystatin C - blood
Female
Glomerular Filtration Rate
Humans
Intensive Care Units
Kidney Diseases - diagnosis
Kidney Function Tests
Male
Measurement
Middle Aged
Physiological aspects
Polypeptides
Retrospective Studies
Young Adult
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Summary:PURPOSEThe predictive performance of glomerular filtration rate (GFR) estimation equations based on cystatin C versus serum creatinine (SCr) values in critically ill patients was evaluated. METHODSA 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 (CLcr24hr) levels. The following equations were also used to determine the estimated GFR that was compared with the reference CLcr24hr for all patients in the studyArnal-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). RESULTSThis study included 241 measurements corresponding to 131 critically ill patients. The cystatin C–based equation underestimated CLcr24hr, whereas overestimation by every SCr-based formula was observed in the whole cohort and in the CLcr24hr < 60 mL/min/1.73 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 CLcr24hr of
ISSN:1079-2082
1535-2900
DOI:10.2146/ajhp140852