Cystatin C-based equations for estimating glomerular filtration rate do not require race or sex coefficients

Estimation or measurement of glomerular filtration rate (GFR) is generally required for optimal treatment of patients. Plasma creatinine has been used for estimation of GFR since 1926 and plasma cystatin C since 1979. The creatinine level is strongly dependent upon muscle mass and as the average mus...

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Bibliographic Details
Published in:Scandinavian journal of clinical and laboratory investigation 2022-04, Vol.82 (2), p.162-166
Main Authors: Ottosson Frost, Carl, Gille-Johnson, Per, Blomstrand, Emanuel, St-Aubin, Viggo, Leion, Felicia, Grubb, Anders
Format: Article
Language:English
Subjects:
Basic Medicine
Clinical Medicine
Creatinine
Creatinine, cystatin C, glomerular filtration rate, race, sex
Cystatin C
glomerular filtration rate
Glomerular Filtration Rate - physiology
Humans
Kidney Function Tests
Klinisk medicin
Läkemedelskemi
Medical and Health Sciences
Medicin och hälsovetenskap
Medicinal Chemistry
Medicinska och farmaceutiska grundvetenskaper
race
Renal Insufficiency, Chronic
sex
Urologi och njurmedicin
Urology and Nephrology
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Summary:Estimation or measurement of glomerular filtration rate (GFR) is generally required for optimal treatment of patients. Plasma creatinine has been used for estimation of GFR since 1926 and plasma cystatin C since 1979. The creatinine level is strongly dependent upon muscle mass and as the average muscle mass of different populations may vary, creatinine-based GFR-estimating equations have since 1999 used more than 10 different race coefficients to improve the diagnostic performance of such equations. But 'race' cannot be determined by biological measurements and is thus an ill-defined biological entity and controversial as it involves self-reporting and social considerations. In contrast, cystatin C-levels are virtually independent of muscular mass and cystatin C-based GFR-estimating equations do not require race coefficients for reliable estimation of GFR. The use of cystatin C-based GFR-estimating equations, alone or in conjunction with creatinine-based GFR-estimating equations, is therefore highly recommended to eliminate the use of race coefficients in estimating GFR. Although sex is a more biology-oriented parameter than race, sex terms may in some cases be controversial, involving self-reporting and social considerations. However, sex terms are not required for adequate estimation of GFR using cystatin C-based equations.
ISSN:0036-5513
1502-7686
1502-7686
DOI:10.1080/00365513.2022.2031279