title: Proteinuria, (99m) Tc-DTPA Scintigraphy, Creatinine-, Cystatin- and Combined-Based Equations in the Assessment of Chronic Kidney Disease.
abstract: Background. Precise estimation of the glomerular filtration rate (GFR) and the identification of markers of progression are important. We compared creatinine, cystatin, and combined CKD-EPI equations with (99m)Tc-DTPA scintigraphy to measure GFR and proteinuria as markers of progression. Methods. Cross-sectional, observational study including 300 subjects. CKD was classified by (99m)Tc-DTPA scintigraphy. Determinations. Creatinine, 24-hour creatinine clearance, cystatin, Hoek formula, and creatinine, cystatin, and combined CKD-EPI equations. Results. In the global assessment, creatinine CKD-EPI and combined CKD-EPI equations yielded the highest correlations with (99m)Tc-DTPA: ρ = 0.839, P < 0.0001 and ρ = 0.831, P < 0.0001. Intergroup analysis versus (99m)Tc-DTPA: control G, creatinine clearance ρ = 0.414, P = 0.013; G3, combined CKD-EPI ρ = 0.5317, P < 0.0001; G4, Hoek ρ = 0.618, P < 0.0001, combined CKD-EPI ρ = 0.4638, P < 0.0001; and G5, creatinine clearance ρ = 0.5414, P < 0.0001, combined CKD-EPI ρ = 0.5288, P < 0.0001. In the global assessment, proteinuria displayed the highest significant correlations with cystatin ( ρ = 0.5433, P < 0.0001) and cystatin-based equations (Hoek: ρ = -0.5309, P < 0.0001). When GFR < 60 mL/min: in stage 3, proteinuria-cystatin ( ρ = 0.4341, P < 0.0001); proteinuria-Hoek ( ρ = -0.4105, P < 0.0001); in stage 4, proteinuria-cystatin ( ρ = 0.4877, P < 0.0001); proteinuria-Hoek ( ρ = -0.4877, P = 0.0026). Conclusions. At every stage of GFR < 60 mL/min, cystatin-based equations displayed better correlations with (99m)Tc-DTPA. Proteinuria and cystatin-based equations showed strong associations and high degrees of correlation.
authors: Servicios de Nefrología, Hospital Británico de Buenos Aires, Perdriel 74, 1280 Buenos Aires, Argentina.
authors: Hernán
authors: H
authors: Trimarchi
authors: Laboratorio Central, Hospital Británico de Buenos Aires, Perdriel 74, 1280 Buenos Aires, Argentina.
authors: Alexis
authors: A
authors: Muryan
authors: Laboratorio Central, Hospital Británico de Buenos Aires, Perdriel 74, 1280 Buenos Aires, Argentina.
authors: Agostina
authors: A
authors: Toscano
authors: Servicios de Medicina Nuclear, Hospital Británico de Buenos Aires, Perdriel 74, 1280 Buenos Aires, Argentina.
authors: Diana
authors: D
authors: Martino
authors: Servicios de Nefrología, Hospital Británico de Buenos Aires, Perdriel 74, 1280 Buenos Aires, Argentina.
authors: Mariano
authors: M
authors: Forrester
authors: Servicios de Nefrología, Hospital Británico de Buenos Aires, Perdriel 74, 1280 Buenos Aires, Argentina.
authors: Vanesa
authors: V
authors: Pomeranz
authors: Servicios de Nefrología, Hospital Británico de Buenos Aires, Perdriel 74, 1280 Buenos Aires, Argentina.
authors: Fernando
authors: F
authors: Lombi
authors: Servicios de Clínica Médica, Hospital Británico de Buenos Aires, Perdriel 74, 1280 Buenos Aires, Argentina.
authors: Pablo
authors: P
authors: Young
authors: Servicios de Nefrología, Hospital Británico de Buenos Aires, Perdriel 74, 1280 Buenos Aires, Argentina.
authors: María Soledad
authors: MS
authors: Raña
authors: Servicios de Nefrología, Hospital Británico de Buenos Aires, Perdriel 74, 1280 Buenos Aires, Argentina.
authors: Alejandra
authors: A
authors: Karl
authors: Laboratorio Central, Hospital Británico de Buenos Aires, Perdriel 74, 1280 Buenos Aires, Argentina.
authors: M
authors: M
authors: Alonso
authors: Laboratorio Central, Hospital Británico de Buenos Aires, Perdriel 74, 1280 Buenos Aires, Argentina.
authors: Mariana
authors: M
authors: Dicugno
authors: Servicios de Medicina Nuclear, Hospital Británico de Buenos Aires, Perdriel 74, 1280 Buenos Aires, Argentina.
authors: Clara
authors: C
authors: Fitzsimons