title: Performance of the creatinine and cystatin C-based equations for estimation of GFR in Chinese patients with chronic kidney disease.
abstract: BACKGROUND
  Currently, creatinine- or cystatin C-based glomerular filtration rate (GFR) estimation equation has been recommended to assess GFR in CKD patients. However, it is still obscure whether those equations performed consistently outstandingly in Chinese population.
  
  
  METHODS
  The equations were validated in a population totaling 632 participants (mean age 61.6 ± 12.3 years). The estimated GFR (eGFR) calculated separately by six equations (C-MDRD, Ccys, Cscr-cys, CKD-EPIscr, CKD-EPIcys, and CKD-EPIscr-cysequations) was compared with the reference GFR (rGFR) measured by the99mTc-DTPA renal dynamic imaging method. Participants were divided into age and rGFR specific subgroups.
  
  
  RESULTS
  CKD-EPIscr-cysequation had a larger area under receiver operating characteristic curve (ROCAUC) and relative higher sensitivity (79.8 %) and specificity (93 %) to diagnose CKD. CKD-EPIscr-cysand CKD-EPIcysequations appeared to be more accurate with higher proportion of eGFR within 30 % of rGFR (P30) value. Those two equations performed as well in older people as in the younger population. The CKD-EPIscr-cysequation acquired the highest P30(80.9 %) in subgroups with rGFR ≥60 mL/min/1.73 m2, while the CKD-EPIcysequation yielded the best performance in the rGFR <60 mL/min/1.73 m2subgroup.
  
  
  CONCLUSIONS
  CKD-EPIscr-cysformula had better capability to accurately evaluate GFR in the participants CKD stages 1-2 in Chinese ethnic. The application of the cystatin C-based equations may be the optimal one for patients of moderately to severely injured GFR. Considering the accuracy in the entire range of participants less ideally, the additional of the Chinese racial factor is assumed to be essential.
authors.affiliation: Division of Nephrology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
authors.forename: Min
authors.initials: M
authors.lastname: Yang
authors.affiliation: Division of Nephrology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
authors.forename: Guang
authors.initials: G
authors.lastname: Xu
authors.affiliation: Division of Nephrology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
authors.forename: Lilu
authors.initials: L
authors.lastname: Ling
authors.affiliation: Division of Nephrology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
authors.forename: Jianying
authors.initials: J
authors.lastname: Niu
authors.affiliation: Division of Nuclear Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
authors.forename: Tong
authors.initials: T
authors.lastname: Lu
authors.affiliation: Division of Nephrology, Nanjing First Hospital, Nanjing Medical University, Chang Le Road 68, Nanjing, 210006, China. duxin168@163.com.
authors.forename: Xin
authors.identifier: http://orcid.org/0000-0002-7273-2337
authors.initials: X
authors.lastname: Du
authors.affiliation: Division of Nephrology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China. yonggu@vip.163.com.|Division of Nephrology, Huashan Hospital, Shanghai Fifth People's Hospital, Fudan University, 801 Heqing Road, Minhang District, Shanghai, 200240, China. yonggu@vip.163.com.
authors.forename: Yong
authors.initials: Y
authors.lastname: Gu
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D002681:China; D003404:Creatinine / Q000097:blood*; D055316:Cystatin C / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011237:Predictive Value of Tests; D012372:ROC Curve; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology; D015203:Reproducibility of Results; D016284:Technetium Tc 99m Pentetate / Q000008:administration & dosage
chemical_list: D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D019275:Radiopharmaceuticals; D003404:Creatinine; D016284:Technetium Tc 99m Pentetate
keywords: Chinese population; Creatinine; Cystatin C; Equation; Glomerular filtration rate