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Estimating Glomerular Filtration Rate from Serum Myo-Inositol, Valine, Creatinine and Cystatin C
| Content Provider | MDPI |
|---|---|
| Author | Frank, Stämmler Grassi, Marcello Meeusen, Jeffrey W. Lieske, John C. Dasari, Surendra Dubourg, Laurence Lemoine, Sandrine Ehrich, Jochen Schiffer, Eric |
| Copyright Year | 2021 |
| Description | Assessment of renal function relies on the estimation of the glomerular filtration rate (eGFR). Existing eGFR equations, usually based on serum levels of creatinine and/or cystatin C, are not uniformly accurate across patient populations. In the present study, we expanded a recent proof-of-concept approach to optimize an eGFR equation targeting the adult population with and without chronic kidney disease (CKD), based on a nuclear magnetic resonance spectroscopy (NMR) derived ‘metabolite constellation’ $(GFR_{NMR}$). A total of 1855 serum samples were partitioned into development, internal validation and external validation datasets. The new $GFR_{NMR}$ equation used serum myo-inositol, valine, creatinine and cystatin C plus age and sex. $GFR_{NMR}$ had a lower bias to tracer measured GFR (mGFR) than existing eGFR equations, with a median bias (95% confidence interval [CI]) of 0.0 (−1.0; 1.0) mL/min/1.73 $m^{2}$ for $GFR_{NMR}$ vs. −6.0 (−7.0; −5.0) mL/min/1.73 $m^{2}$ for the Chronic Kidney Disease Epidemiology Collaboration equation that combines creatinine and cystatin C $(CKD-EPI_{2012}$) (p < 0.0001). Accuracy (95% CI) within 15% of mGFR (1-P15) was 38.8% (34.3; 42.5) for $GFR_{NMR}$ vs. 47.3% (43.2; 51.5) for $CKD-EPI_{2012}$ (p < 0.010). Thus, $GFR_{NMR}$ holds promise as an alternative way to assess eGFR with superior accuracy in adult patients with and without CKD. |
| Starting Page | 2291 |
| e-ISSN | 20754418 |
| DOI | 10.3390/diagnostics11122291 |
| Journal | Diagnostics |
| Issue Number | 12 |
| Volume Number | 11 |
| Language | English |
| Publisher | MDPI |
| Publisher Date | 2021-12-07 |
| Access Restriction | Open |
| Subject Keyword | Diagnostics Biochemical Research Glomerular Filtration Rate Egfr Filtration Markers Metabolite Nmr Chronic Kidney Disease Ckd Egfr Equation Serum Creatinine Cystatin C |
| Content Type | Text |
| Resource Type | Article |
