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<p>We investigated the performances of serum creatinine (SCR), cystatin C (CysC), and combined (SCR-CysC) estimated glomerular filtration rates (eGFR) in predominantly elderly African-American male population with discordant laboratory values. Retrospective analysis of concurrent serum creatinine-cystatin C measurements utilizing Pearson correlation coefficient and estimation of the kappa statistic to investigate the correlation and agreement between these different eGFR methods. Analysis included 150 males with mean eGFR<sub>SCR</sub> and eGFR<sub>CysC</sub> of 46.34 ± 1.55&#xa0;mL/min/1.73 m<sup>2</sup> and 38.94 ± 01.53&#xa0;mL/min/1.73 m<sup>2</sup>, respectively. SCR demonstrated high correlation with CysC (<i>r</i> = 0.79, CI<sub>95%</sub> 0.72–0.84). There was high correlation between eGFR<sub>SCR</sub> and eGFR<sub>SCR-CysC</sub> (<i>r</i> = 0.87, CI<sub>95%</sub> 0.83–0.90) but only moderate correlation with eGFR<sub>CysC</sub> (<i>r</i> = 0.66, CI<sub>95%</sub> 0.56–0.74). In stage 3a chronic kidney disease, the correlation of eGFR<sub>SCR</sub> with eGFR<sub>CysC</sub> and eGFR<sub>SCR-CysC</sub> was minimal (r = 0.16, CI<sub>95%</sub> − 0.14–0.44) and low positive (<i>r</i> = 0.36, CI<sub>95%</sub> 0.06–0.60), respectively. In patients &lt; 65&#xa0;years, eGFR<sub>SCR</sub> showed high correlation with eGFR<sub>SCR-CysC</sub> (<i>r</i> = 0.76, CI<sub>95%</sub> 0.60–0.86); in patients ≥ 65&#xa0;years, eGFR<sub>SCR</sub> showed very high correlation with eGFR<sub>SCR-CysC</sub> (<i>r</i> = 0.90, CI<sub>95%</sub> 0.86–0.93). Moderate correlations were observed between eGFR<sub>SCR</sub> and eGFR<sub>CysC</sub> in those with normal (<i>r</i> = 0.67, CI<sub>95%</sub> 0.42–0.83) and overweight/obese (<i>r</i> = 0.65, CI<sub>95%</sub> 0.52–0.74) body mass index (BMI). However, the agreement between eGFR<sub>SCR</sub> and eGFR<sub>CysC</sub> categories were minimal overall (kappa = 0.19, CI<sub>95%</sub> 0.10–0.27). Agreement was moderate for eGFR<sub>Cr</sub> vs. eGFR<sub>Cr-CysC</sub> (kappa = 0.44 (CI<sub>95%</sub> 0.35–0.53) and eGFR<sub>CysC</sub> vs. eGFR<sub>Cr-CysC</sub> (kappa = 0.53 (CI<sub>95%</sub> 0.44–0.62). Our data suggest minimal agreement between SCR, CysC, and combined eGFR categories in a predominantly African-American male population with high comorbidities and advanced chronic kidney disease.</p>

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Serum Creatinine, Cystatin C, and Combined eGFRs in High-Risk CKD Patients

  • 期刊论文

  • 发表日期：

    2025年3月27日

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  • A. Ahsan Ejaz,
  • Ami M. Patel,
  • Evan I. Fisher,
  • Maria C. Browne,
  • Stephen L. Seliger

摘要

We investigated the performances of serum creatinine (SCR), cystatin C (CysC), and combined (SCR-CysC) estimated glomerular filtration rates (eGFR) in predominantly elderly African-American male population with discordant laboratory values. Retrospective analysis of concurrent serum creatinine-cystatin C measurements utilizing Pearson correlation coefficient and estimation of the kappa statistic to investigate the correlation and agreement between these different eGFR methods. Analysis included 150 males with mean eGFRSCR and eGFRCysC of 46.34 ± 1.55 mL/min/1.73 m2 and 38.94 ± 01.53 mL/min/1.73 m2, respectively. SCR demonstrated high correlation with CysC (r = 0.79, CI95% 0.72–0.84). There was high correlation between eGFRSCR and eGFRSCR-CysC (r = 0.87, CI95% 0.83–0.90) but only moderate correlation with eGFRCysC (r = 0.66, CI95% 0.56–0.74). In stage 3a chronic kidney disease, the correlation of eGFRSCR with eGFRCysC and eGFRSCR-CysC was minimal (r = 0.16, CI95% − 0.14–0.44) and low positive (r = 0.36, CI95% 0.06–0.60), respectively. In patients < 65 years, eGFRSCR showed high correlation with eGFRSCR-CysC (r = 0.76, CI95% 0.60–0.86); in patients ≥ 65 years, eGFRSCR showed very high correlation with eGFRSCR-CysC (r = 0.90, CI95% 0.86–0.93). Moderate correlations were observed between eGFRSCR and eGFRCysC in those with normal (r = 0.67, CI95% 0.42–0.83) and overweight/obese (r = 0.65, CI95% 0.52–0.74) body mass index (BMI). However, the agreement between eGFRSCR and eGFRCysC categories were minimal overall (kappa = 0.19, CI95% 0.10–0.27). Agreement was moderate for eGFRCr vs. eGFRCr-CysC (kappa = 0.44 (CI95% 0.35–0.53) and eGFRCysC vs. eGFRCr-CysC (kappa = 0.53 (CI95% 0.44–0.62). Our data suggest minimal agreement between SCR, CysC, and combined eGFR categories in a predominantly African-American male population with high comorbidities and advanced chronic kidney disease.