title: Comparison of creatinine and cystatin formulae with51Chromium-ethylenediaminetetraacetic acid glomerular filtration rate in patients with decompensated cirrhosis.
abstract: OBJECTIVE
  Evaluation of renal function, that is, glomerular filtration rate (GFR), has become very important, but conventional mathematical formulae for GFR assessment are inaccurate in patients with cirrhosis. The aim of the present study was to compare serum creatinine (sCr)-based and serum cystatin C (cysC)-based estimated GFR (eGFR) formulae with51Chromium-ethylenediaminetetraacetic acid GFR (51Chr-GFR) in patients with stable decompensated cirrhosis.
  
  
  METHODS
  In 129 Caucasian patients with decompensated cirrhosis, we assessed sCr-based GFRs [Modification of Diet in Renal Disease and chronic kidney disease-epidemiology (CKD-EPI)-sCr formulae], cysC-based GFRs [Hoek, Larsson, and CKD-EPI-cysC equations], and the mathematical formulae, which combined both sCr and cysC [i.e. CKD-EPI-sCr-cysC and the specific for cirrhotics formula recently proposed by Mindikoglu et al. (Mindikoglu-eGFR)]. Multivariate linear regression analysis was used for GFR predictors in our cohort.
  
  
  RESULTS
  The correlations between51Chr-GFR and all mathematical formulae were good (Spearman r2> 0.68, P < 0.001). Modification of Diet in Renal Disease and CKD-EPI-sCr had lower bias (6.6 and -4.8, respectively), compared with the other eGFRs, while Mindikoglu-eGFR and CKD-EPI-sCr-cysC formulae had greater precision (17.1 and 17.3, respectively), compared with the other eGFRs. CKD-EPI-sCr and Mindikoglu-eGFR had higher accuracy (39% and 41%, respectively), compared with the other eGFRs. The factors independently associated with the51Chr-GFR were age, cysC, and sCr, and the new derived formula had lower bias (0.89) and similar precision (17.2) and accuracy (41%) with Mindikoglu-eGFR formula.
  
  
  CONCLUSIONS
  The specific mathematical formulae derived from patients with cirrhosis seem to provide superior assessment of renal function, compared with the conventional used sCr-based and cysC-based formulae.
authors.affiliation: 4th Department of Internal Medicine, Hippokration General Hospital of Thessaloniki, Medical School of Aristotle University, Thessaloniki, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Cholongitas
authors.affiliation: 4th Department of Internal Medicine, Hippokration General Hospital of Thessaloniki, Medical School of Aristotle University, Thessaloniki, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Ioannidou
authors.affiliation: 4th Department of Internal Medicine, Hippokration General Hospital of Thessaloniki, Medical School of Aristotle University, Thessaloniki, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Goulis
authors.affiliation: 4th Department of Internal Medicine, Hippokration General Hospital of Thessaloniki, Medical School of Aristotle University, Thessaloniki, Greece.
authors.forename: Parthenis
authors.initials: P
authors.lastname: Chalevas
authors.affiliation: Biochemical Department, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece.
authors.forename: Fani
authors.initials: F
authors.lastname: Ntogramatzi
authors.affiliation: Biochemical Department, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece.
authors.forename: Zoi
authors.initials: Z
authors.lastname: Athanasiadou
authors.affiliation: Department of Nuclear Medicine, Medical School of Aristotle University, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Notopoulos
authors.affiliation: Department of Nuclear Medicine, Medical School of Aristotle University, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece.
authors.forename: Manolis
authors.initials: M
authors.lastname: Alevroudis
authors.affiliation: 4th Department of Internal Medicine, Hippokration General Hospital of Thessaloniki, Medical School of Aristotle University, Thessaloniki, Greece.
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Sinakos
authors.affiliation: 4th Department of Internal Medicine, Hippokration General Hospital of Thessaloniki, Medical School of Aristotle University, Thessaloniki, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Akriviadis
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002857:Chromium; D003404:Creatinine / Q000097:blood*; D015891:Cystatins / Q000097:blood*; D004492:Edetic Acid; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008111:Liver Function Tests / Q000379:methods*; D008297:Male; D008433:Mathematics / Q000379:methods; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D015891:Cystatins; D002857:Chromium; D004492:Edetic Acid; D003404:Creatinine
keywords: cirrhosis; decompensated cirrhosis; glomerular filtration rate; renal function