Predictive performance of glomerular filtration rate estimation equations based on cystatin C versus serum creatinine values in critically ill patients.

Purpose. The predictive performance of glomerular filtration rate (GFR) estimation equations based on cystatin C versus serum creatinine (SCr) values in critically ill patients was evaluated. Methods. A retrospective observational study was performed in the medical intensive care unit (ICU) of a uni...

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Publicado en:American Journal of Health-System Pharmacy Vol. 73; no. 4; pp. 206 - 216
Autores principales: Diego, Elisa, Castro, Pedro, Soy, Dolors, Poch, Esteban, Nicolás, Josep M.
Formato: equations & formulas research tables/charts Journal Article
Publicado: Oxford University Press / USA 2/15/2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2/15/2016
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      pub: Oxford University Press / USA
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        10.2146/ajhp140852
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        atl: Predictive performance of glomerular filtration rate estimation equations based on cystatin C versus serum creatinine values in critically ill patients.
      aug:
        au:
          Diego, Elisa
          Castro, Pedro
          Soy, Dolors
          Poch, Esteban
          Nicolás, Josep M.
        affil: Pharmacy Department, Hospital Clinic of Barcelona, Institut D'Investigacions Biomediques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
      sug:
        subj:
          Glomerular Filtration Rate
          Critically Ill Patients
          Creatinine Blood
          Proteins
          Human
          Retrospective Design
          Nonexperimental Studies
          Intensive Care Units
          Academic Medical Centers
          Serum Albumin
          Blood Urea Nitrogen
          Creatinine Urine
          Data Analysis Software
          Descriptive Statistics
          Pearson's Correlation Coefficient
          Adolescence
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
      ab: Purpose. The predictive performance of glomerular filtration rate (GFR) estimation equations based on cystatin C versus serum creatinine (SCr) values in critically ill patients was evaluated. Methods. A retrospective observational study was performed in the medical intensive care unit (ICU) of a university hospital from October 2006 through September 2007. All consecutively admitted critically ill patients older than 18 years who stayed in the ICU for more than 48 hours with a urinary bladder catheter in place were included in the study. Data collected included SCr, cystatin C, serum albumin, blood urea nitrogen, and 24-hour urine creatinine clearance (CL...) levels. The following equations were also used to determine the estimated GFR that was compared with the reference CL... for all patients in the study: Arnal-Dade using cystatin C, Cockcroft-Gault using actual body weight, Cockcroft-Gault using ideal body weight, Jelliffe, Modification of Diet in Renal Disease (MDRD), and four-variable version MDRD (MDRD-4). Results. This study included 241 measurements corresponding to 131 critically ill patients. The cystatin C-based equation underestimated CL..., whereas overestimation by every SCr-based formula was observed in the whole cohort and in the CL...< 60 mL/min/1.73 m² subgroup; MDRD-4 was the most biased equation in every analysis. There were no significant differences in precision, except for great variability in the subgroup with a CL... of <60 mL/min/1.73 m ², where the MDRD equation showed better results than the cystatin C-based equation (33.5% versus 38.9%). No equations fulfilled concordance requirements with CL.... Conclusion. A retrospective observational study showed no evidence of superiority of a cystatin C-based equation over SCr-based equations to estimate the GFR in an ICU population.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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