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Abstract
The level of glomerular filtration rate (GFR) generally is accepted as the best overall index for the complex functions of the kidney in health and disease based on functional, pathological, clinical, and prognostic factors,for this reason, CKD is defined based on the level of GFR.
Clinical recommendations for individuals at increased risk of CKD and for patients at each stage of CKD include assessment of GFR.
Inulin clearance is considered the gold standard method to determine GFR.
Its measurement is, however cumbersome as it requires constant infusion and its measurement is time consuming.
Serum creatinine levels affected by many factors such as age, race, muscle mass, gender, medication use and catabolic state.
All these factors are independent of changes in GFR.
Various serum creatinine based equations have been developed in an attempt to improve the estimation of GFR from serum creatinine.
Recently, several prediction equations have been derived from both pediatric and adult patients to estimate GFR from the cystatin C concentration.
Serum cystatin C and cystatin C based equation were extensively studied in relation to serum creatinine and serum creatinine based equations in adults, pediatric and elderly populations as well as transplant and non transplant patients.
The results were conflicting and did not show uniform superiority of one of them.
This study involves 101 adult chronic kidney disease patients.
All of them underwent measurement of serum creatinine, serum cystatin C concentrations and assessment of GFR using the gold standard method PDF inulin clearance.
The distribution of the patient’s GFR involves all the 5 CKD stages.
We tested 15 Creatinine based and 9 cystatin C based equations.
Comparison between prediction equations was performed in total population and in subgroups in different CKD stages for the most common and the highest accurate equations.