Performance of Cystatin C-Based Equations for Estimation of Glomerular Filtration Rate in Diabetes Patients: A Prisma-Compliant Systematic Review and Meta-Analysis

The accuracy of estimated glomerular filtration rate (eGFR) equations in diabetes mellitus (DM) patients has been extensively questioned. We evaluated the performance of cystatin C-based equations alone or in combination with creatinine to estimate GFR in DM patients. A PRISMA-compliant systematic r...

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Bibliographic Details
Published in:Scientific reports 2019-02, Vol.9 (1), p.1418-1418, Article 1418
Main Authors: Cheuiche, Amanda Veiga, Queiroz, Marina, Azeredo-da-Silva, André Luis Ferreira, Silveiro, Sandra Pinho
Format: Article
Language:English
Subjects:
692/163/2743/137/138
692/4022/1585/104
Creatinine
Cystatin C
Diabetes
Diabetes mellitus
Epidermal growth factor receptors
Glomerular filtration rate
Humanities and Social Sciences
Meta-analysis
multidisciplinary
Science
Science (multidisciplinary)
Sensitivity analysis
Systematic review
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Summary:The accuracy of estimated glomerular filtration rate (eGFR) equations in diabetes mellitus (DM) patients has been extensively questioned. We evaluated the performance of cystatin C-based equations alone or in combination with creatinine to estimate GFR in DM patients. A PRISMA-compliant systematic review was performed in the MEDLINE and Embase databases, with “diabetes mellitus” and “cystatin C” as search terms. Studies comparing cystatin C-based eGFR equations with measured GFR (mGFR) in DM patients were eligible. Accuracies P10, P15, P20, and P30 indicated the proportion of eGFR results within 10, 15, 20, and 30% of mGFR. Single-arm meta-analyses were conducted, and the Quality of Diagnostic Accuracy Studies-II tool (QUADAS-2) was applied. Twenty-three studies comprising 7065 participants were included, and 24 equations were analyzed in a broad range of GFRs. Meta-analyses were completed for 10 equations. The mean P30 accuracies of the equations ranged from 41% to 87%, with the highest values found with both CKD-EPI equations. Mean P10-P15 achieved 35% in the best scenario. A sensitivity analysis to evaluate different mGFR methods did not change results. In conclusion, cystatin C-based eGFR equations represent measured GFR fairly at best in DM patients, with high variability among the several proposed equations.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-018-38286-9