Title: Generation of a new cystatin C–based estimating equation for glomerular filtration rate by use of 7 assays standardized to the international calibrator
Authors: GRUBB AndersHORIO MasaruHANSSON Lars-OlofBJORK JonasNYMAN UlfFLODIN M.LARSSON AndersBÖKENKAMP ArendYASUDA YoshinariBLUFPAND HesterLINDSTROM VeronicaZEGERS IngridALTHAUS HaraldBLIRUP-JENSEN SorenITOH YoshiSJÖSTRÖM PerNORDIN GunnarCHRISTENSSON AndersKLIMA HorstSUNDE KathrinHJORT-CHRISTENSEN PerARMBRUSTER DavidFerrero Carlo
Citation: CLINICAL CHEMISTRY vol. 60 no. 7 p. 974-986
Publisher: AMER ASSOC CLINICAL CHEMISTRY
Publication Year: 2014
JRC N°: JRC85474
ISSN: 0009-9147
URI: http://dx.doi.org/10.1373/clinchem.2013.220707
http://publications.jrc.ec.europa.eu/repository/handle/JRC85474
DOI: 10.1373/clinchem.2013.220707
Type: Articles in periodicals and books
Abstract: BACKGROUND: Many different cystatin C–based equations exist for estimating glomerular filtration rate. Major reasons for this are the previous lack of an international cystatin C calibrator and the nonequivalence of results from different cystatin C assays. METHODS: Use of the recently introduced certified reference material, ERM-DA471/IFCC, and further work to achieve high agreement and equivalence of 7 commercially available cystatin C assays allowed a substantial decrease of the CV of the assays, as defined by their performance in an external quality assessment for clinical laboratory investigations. By use of 2 of these assays and a population of 4690 subjects, with large subpopulations of children and Asian and Caucasian adults, with their GFR determined by either renal or plasma inulin clearance or plasma iohexol clearance, we attempted to produce a virtually assay-independent simple cystatin C–based equation for estimation of GFR. RESULTS: We developed a simple cystatin C–based equation for estimation of GFR comprising only 2 variables, cystatin C concentration and age. No terms for race and sex are required for optimal diagnostic performance. The equation, eGFR=130 x cystatin C-1.069 x age-0.117 - 7, is also biologically oriented, with 1 term for the theoretical renal clearance of small molecules and 1 constant for extrarenal clearance of cystatin C. CONCLUSIONS: A virtually assay-independent simple cystatin C–based and biologically oriented equation for estimation of GFR, without terms for sex and race, was produced.
JRC Directorate:Health, Consumers and Reference Materials

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