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Comparing the GFR estimation equations using both creatinine and cystatin c to predict the long-term renal outcome in type 2 diabetic nephropathy patients

Abstract Aims This study aimed to determine whether eGFRcre-cys and its slope could improve the prediction of the long-term renal outcome in patients with type 2 diabetic nephropathy (DN). Methods The cross-sectional and longitudinal analyses included 501 type 2DN patients from 2003 to 2009. GFR was... Full description

Journal Title: Journal of diabetes and its complications 2016, Vol.30 (8), p.1478-1487
Main Author: Pan, Yu
Other Authors: Jiang, Song , Qiu, Dandan , Shi, Jingsong , Zhou, Minlin , An, Yu , Ge, Yongchun , Xie, Honglang , Liu, Zhihong
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: United States: Elsevier Inc
ID: ISSN: 1056-8727
Link: https://www.ncbi.nlm.nih.gov/pubmed/27593903
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title: Comparing the GFR estimation equations using both creatinine and cystatin c to predict the long-term renal outcome in type 2 diabetic nephropathy patients
format: Article
creator:
  • Pan, Yu
  • Jiang, Song
  • Qiu, Dandan
  • Shi, Jingsong
  • Zhou, Minlin
  • An, Yu
  • Ge, Yongchun
  • Xie, Honglang
  • Liu, Zhihong
subjects:
  • Adult
  • Analysis
  • Biomarkers - blood
  • Chronic kidney failure
  • Creatinine - blood
  • Cross-Sectional Studies
  • Cystatin C
  • Cystatin C - blood
  • Diabetes
  • Diabetes Mellitus, Type 2 - blood
  • Diabetes Mellitus, Type 2 - complications
  • Diabetic nephropathies
  • Diabetic Nephropathies - blood
  • Diabetic Nephropathies - diagnosis
  • Diabetic retinopathy
  • eGFR slopes
  • Endocrinology & Metabolism
  • Estimating equations
  • Glomerular Filtration Rate
  • Humans
  • Kidney diseases
  • Laboratories
  • Longitudinal Studies
  • Medical research
  • Medicine, Experimental
  • Middle Aged
  • Mortality
  • Patient outcomes
  • Prognosis
  • Renal outcome
  • Type 2 diabetic nephropathy
ispartof: Journal of diabetes and its complications, 2016, Vol.30 (8), p.1478-1487
description: Abstract Aims This study aimed to determine whether eGFRcre-cys and its slope could improve the prediction of the long-term renal outcome in patients with type 2 diabetic nephropathy (DN). Methods The cross-sectional and longitudinal analyses included 501 type 2DN patients from 2003 to 2009. GFR was estimated using either eGFRcre-cys or the serum creatinine-based equation (eGFRcre) or the cystatin C-based equation (eGFRcys), and was classified into 3 categories (≥ 90, 60–90, ≤ 60 ml/min per 1.73m2 ). The proportion of patients was evaluated in each creatinine-calculated eGFR category for which the category was reclassified based on either cystatin C or the combined measurement. Long-term changes in eGFRcre-cys, eGFRcys and eGFRcre were estimated using linear mixed effect models. The receiver operating characteristic (ROC) curves was applied to study the sensitivity and specificity of different eGFR slopes for predicting the renal endpoint. Results In the cross-sectional analyses, eGFRcre was overestimated compared to eGFRcre-cys [median bias − 8.5 (95% CI: − 25.01, 1.21)]. The reclassification of eGFRcre to a higher value was associated with an increased risk of ESRD [OR: 4.01 (95% CI: 2.36 to 6.82)]. In the longitudinal analyses for predicting end-stage renal disease (ERSD), the ROC curves for eGFRcre-cys (AUC = 0.86 ± 0.03) over 24 months were increased compared with the ROC curves for eGFRcre and eGFRcys ( p < 0.05). Conclusions The study suggests that the eGFRcre-cys equation may be more precise and sensitive for predicting the renal outcome in T2DN patients. Tracking renal decline using eGFRcre-cys may be used as a surrogate for determining the renal endpoint in a clinical setting.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1056-8727
fulltext: fulltext
issn:
  • 1056-8727
  • 1873-460X
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titleComparing the GFR estimation equations using both creatinine and cystatin c to predict the long-term renal outcome in type 2 diabetic nephropathy patients
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creatorPan, Yu ; Jiang, Song ; Qiu, Dandan ; Shi, Jingsong ; Zhou, Minlin ; An, Yu ; Ge, Yongchun ; Xie, Honglang ; Liu, Zhihong
creatorcontribPan, Yu ; Jiang, Song ; Qiu, Dandan ; Shi, Jingsong ; Zhou, Minlin ; An, Yu ; Ge, Yongchun ; Xie, Honglang ; Liu, Zhihong
descriptionAbstract Aims This study aimed to determine whether eGFRcre-cys and its slope could improve the prediction of the long-term renal outcome in patients with type 2 diabetic nephropathy (DN). Methods The cross-sectional and longitudinal analyses included 501 type 2DN patients from 2003 to 2009. GFR was estimated using either eGFRcre-cys or the serum creatinine-based equation (eGFRcre) or the cystatin C-based equation (eGFRcys), and was classified into 3 categories (≥ 90, 60–90, ≤ 60 ml/min per 1.73m2 ). The proportion of patients was evaluated in each creatinine-calculated eGFR category for which the category was reclassified based on either cystatin C or the combined measurement. Long-term changes in eGFRcre-cys, eGFRcys and eGFRcre were estimated using linear mixed effect models. The receiver operating characteristic (ROC) curves was applied to study the sensitivity and specificity of different eGFR slopes for predicting the renal endpoint. Results In the cross-sectional analyses, eGFRcre was overestimated compared to eGFRcre-cys [median bias − 8.5 (95% CI: − 25.01, 1.21)]. The reclassification of eGFRcre to a higher value was associated with an increased risk of ESRD [OR: 4.01 (95% CI: 2.36 to 6.82)]. In the longitudinal analyses for predicting end-stage renal disease (ERSD), the ROC curves for eGFRcre-cys (AUC = 0.86 ± 0.03) over 24 months were increased compared with the ROC curves for eGFRcre and eGFRcys ( p < 0.05). Conclusions The study suggests that the eGFRcre-cys equation may be more precise and sensitive for predicting the renal outcome in T2DN patients. Tracking renal decline using eGFRcre-cys may be used as a surrogate for determining the renal endpoint in a clinical setting.
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subjectAdult ; Analysis ; Biomarkers - blood ; Chronic kidney failure ; Creatinine - blood ; Cross-Sectional Studies ; Cystatin C ; Cystatin C - blood ; Diabetes ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - complications ; Diabetic nephropathies ; Diabetic Nephropathies - blood ; Diabetic Nephropathies - diagnosis ; Diabetic retinopathy ; eGFR slopes ; Endocrinology & Metabolism ; Estimating equations ; Glomerular Filtration Rate ; Humans ; Kidney diseases ; Laboratories ; Longitudinal Studies ; Medical research ; Medicine, Experimental ; Middle Aged ; Mortality ; Patient outcomes ; Prognosis ; Renal outcome ; Type 2 diabetic nephropathy
ispartofJournal of diabetes and its complications, 2016, Vol.30 (8), p.1478-1487
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6Ge, Yongchun
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8Liu, Zhihong
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descriptionAbstract Aims This study aimed to determine whether eGFRcre-cys and its slope could improve the prediction of the long-term renal outcome in patients with type 2 diabetic nephropathy (DN). Methods The cross-sectional and longitudinal analyses included 501 type 2DN patients from 2003 to 2009. GFR was estimated using either eGFRcre-cys or the serum creatinine-based equation (eGFRcre) or the cystatin C-based equation (eGFRcys), and was classified into 3 categories (≥ 90, 60–90, ≤ 60 ml/min per 1.73m2 ). The proportion of patients was evaluated in each creatinine-calculated eGFR category for which the category was reclassified based on either cystatin C or the combined measurement. Long-term changes in eGFRcre-cys, eGFRcys and eGFRcre were estimated using linear mixed effect models. The receiver operating characteristic (ROC) curves was applied to study the sensitivity and specificity of different eGFR slopes for predicting the renal endpoint. Results In the cross-sectional analyses, eGFRcre was overestimated compared to eGFRcre-cys [median bias − 8.5 (95% CI: − 25.01, 1.21)]. The reclassification of eGFRcre to a higher value was associated with an increased risk of ESRD [OR: 4.01 (95% CI: 2.36 to 6.82)]. In the longitudinal analyses for predicting end-stage renal disease (ERSD), the ROC curves for eGFRcre-cys (AUC = 0.86 ± 0.03) over 24 months were increased compared with the ROC curves for eGFRcre and eGFRcys ( p < 0.05). Conclusions The study suggests that the eGFRcre-cys equation may be more precise and sensitive for predicting the renal outcome in T2DN patients. Tracking renal decline using eGFRcre-cys may be used as a surrogate for determining the renal endpoint in a clinical setting.
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8Diabetes
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titleComparing the GFR estimation equations using both creatinine and cystatin c to predict the long-term renal outcome in type 2 diabetic nephropathy patients
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abstractAbstract Aims This study aimed to determine whether eGFRcre-cys and its slope could improve the prediction of the long-term renal outcome in patients with type 2 diabetic nephropathy (DN). Methods The cross-sectional and longitudinal analyses included 501 type 2DN patients from 2003 to 2009. GFR was estimated using either eGFRcre-cys or the serum creatinine-based equation (eGFRcre) or the cystatin C-based equation (eGFRcys), and was classified into 3 categories (≥ 90, 60–90, ≤ 60 ml/min per 1.73m2 ). The proportion of patients was evaluated in each creatinine-calculated eGFR category for which the category was reclassified based on either cystatin C or the combined measurement. Long-term changes in eGFRcre-cys, eGFRcys and eGFRcre were estimated using linear mixed effect models. The receiver operating characteristic (ROC) curves was applied to study the sensitivity and specificity of different eGFR slopes for predicting the renal endpoint. Results In the cross-sectional analyses, eGFRcre was overestimated compared to eGFRcre-cys [median bias − 8.5 (95% CI: − 25.01, 1.21)]. The reclassification of eGFRcre to a higher value was associated with an increased risk of ESRD [OR: 4.01 (95% CI: 2.36 to 6.82)]. In the longitudinal analyses for predicting end-stage renal disease (ERSD), the ROC curves for eGFRcre-cys (AUC = 0.86 ± 0.03) over 24 months were increased compared with the ROC curves for eGFRcre and eGFRcys ( p < 0.05). Conclusions The study suggests that the eGFRcre-cys equation may be more precise and sensitive for predicting the renal outcome in T2DN patients. Tracking renal decline using eGFRcre-cys may be used as a surrogate for determining the renal endpoint in a clinical setting.
copUnited States
pubElsevier Inc
pmid27593903
doi10.1016/j.jdiacomp.2016.07.013