Abstract | BACKGROUND & AIMS: METHODS: From 2010 through 2014, we measured GFR in 103 subjects with cirrhosis based on non-radiolabeled iothalamate plasma clearance. We measured blood levels of creatinine, cystatin C, β-trace protein, β2-microglobulin, L-arginine, and symmetric and asymmetric dimethylarginines simultaneously with GFR. Multivariate linear regression analysis was performed to develop models to estimate GFR. Overall accuracy, defined by the root mean square error (RMSE) of our newly developed model to estimate GFR, was compared with that of the CKD-EPI equations. To obtain an unbiased estimate of our new equation to estimate GFR, we used a leave-one-out cross-validation strategy. RESULTS: After we considered all the candidate variables and blood markers of GFR, the most accurate equation we identified to estimate GFR included serum levels of creatinine and cystatin C, as well as patients' age, sex, and race. Overall, the accuracy of this equation (RMSE = 22.92) was superior to that of the CKD-EPI cystatin C equation (RMSE = 27.27, P = .004). Among subjects with cirrhosis and diuretic-refractory ascites, the accuracy of the equation we developed to estimate GFR (RMSE = 19.36) was greater than that of the CKD-EPI cystatin C (RMSE = 27.30, P = .003) and CKD-EPI creatinine- cystatin C equations (RMSE = 23.37, P = .004). CONCLUSIONS:
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Authors | Ayse L Mindikoglu, Thomas C Dowling, Laurence S Magder, Robert H Christenson, Matthew R Weir, Stephen L Seliger, William R Hutson, Charles D Howell |
Journal | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
(Clin Gastroenterol Hepatol)
Vol. 14
Issue 4
Pg. 624-632.e2
(Apr 2016)
ISSN: 1542-7714 [Electronic] United States |
PMID | 26133903
(Publication Type: Comparative Study, Evaluation Study, Journal Article)
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Copyright | Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Cystatin C
- dimethylarginine
- Arginine
- Creatinine
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Topics |
- Adult
- Aged
- Arginine
(analogs & derivatives, pharmacokinetics)
- Ascites
(complications)
- Creatinine
(pharmacokinetics)
- Cystatin C
(pharmacokinetics)
- Female
- Glomerular Filtration Rate
- Humans
- Kidney Diseases
(diagnosis)
- Kidney Function Tests
(methods)
- Liver Cirrhosis
(complications)
- Male
- Middle Aged
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