title: The assessment of GFR after orthotopic liver transplantation using cystatin C and creatinine-based equations.
abstract: The measurement of kidney function after orthotopic liver transplantation (OLT) is still a clinical challenge. Cystatin C (CysC) has been proposed as a more accurate marker of renal function than serum creatinine (sCr). The aim of this study was to evaluate sCr- and CysC-based equations including the Chronic kidney disease (CKD)-EPI to determine renal function in liver transplant recipients. CysC and sCr were measured in 49 patients 24 months after OLT. The glomerular filtration rate (GFR) was calculated using the MDRD 4, the Cockroft-Gault, Hoek, Larsson, and the CKD-EPI equations based on sCr and/or CysC. As reference method, inulin clearance (IC) was estimated. Bias, precision, and accuracy of each equation were assessed and compared with respect to IC. Forty-five percent had a GFR < 60 ml/min/1.73 m(2) according to the IC. The Larsson, the Hoek and the CKD-EPI-CysC formula identified the highest percentage of patients with CKD correctly (88%, 88%, and 84%, respectively). The sCr-based equations showed less bias than CysC-based formulas with a similar precision. All CysC-based equations were superior as compared with sCr-based equations in the assessment of renal function in patients with an IC < 60 ml/min/1.73 m(2).
authors.affiliation: Department of Surgery, Division of Transplant Surgery, Medical University of Graz, Graz, Austria. doris.wagner@medunigraz.at
authors.forename: Doris
authors.initials: D
authors.lastname: Wagner
authors.forename: Daniela
authors.initials: D
authors.lastname: Kniepeiss
authors.forename: Philipp
authors.initials: P
authors.lastname: Stiegler
authors.forename: Sabine
authors.initials: S
authors.lastname: Zitta
authors.forename: Andrea
authors.initials: A
authors.lastname: Bradatsch
authors.forename: Markus
authors.initials: M
authors.lastname: Robatscher
authors.forename: Helmut
authors.initials: H
authors.lastname: Müller
authors.forename: Andreas
authors.initials: A
authors.lastname: Meinitzer
authors.forename: Astrid
authors.initials: A
authors.lastname: Fahrleitner-Pammer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Wirnsberger
authors.forename: Florian
authors.initials: F
authors.lastname: Iberer
authors.forename: Karlheinz
authors.initials: K
authors.lastname: Tscheliessnigg
authors.forename: Gilbert
authors.initials: G
authors.lastname: Reibnegger
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Rosenkranz
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood*; D055316:Cystatin C / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007165:Immunosuppression Therapy; D007444:Inulin; D007677:Kidney Function Tests / Q000379:methods / Q000706:statistics & numerical data; D016031:Liver Transplantation / Q000276:immunology / Q000502:physiology*; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D007444:Inulin; D003404:Creatinine