Application of serum cystatin C-based eGFR equations in renal function evaluation for kidney transplant recipients / 中华器官移植杂志

ABSTRACT

Objective To compare the differences of the four estimating equations about MDRD,CKD-EPI eGFRcr,CKD-EPI eGFRcys,and eGFRcr-cysin evaluating the renal function of kidney transplant recipients,and explore the optimal equations to estimate the renal allograft function.Method Between January 2000 to March 2015,a total of 213 renal transplant recipients with data integrity were enrolled.eGFR was calculated using the equationsModification of Diet in Renal Dis-ease [eGFR (MDRD),the creatinine-based equation (CKD-EPI eGFRcr),the CKD EPI cystatin C equation (CKD-EPI eGFRcys),and CKD EPI creatinine + cystatin C equation (CKD-EPI eGFRcr-cys) drafted by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) in 2009 and 2012.We assessed the performance of these four eGFR equations by Pearson correlation analysis,Bland-Altman plot,and Cox regression analysis.Result The incidence of reduced kidney function was 49.3％ using MDRD,43.7％ using eGFRcr,49.8％ using eGFRcys,and 52.1％ using eGFRcr-cys,respectively.In recipients with eGFR ≥60 ml·min· 1.73 m2 estimated by MDRD,19.5％ and 11％ had eGFR ＜60 ml·min·1.73 m2 re-estimated by eGFRcys and eGFRcr-cys respectively.Serum cystatin C was significantly correlated with serum creatinine,MDRD,eGFRcr,eGFRcr-cys with the correlation coefficient being 0.67,0.61,0.65,and 0.77 respectively.Only the CKD staging based on eGFRcr,and eGFRcr-cys was positively related to renal graft loss risk.eGFRcr,and eGFRcr-cys could not be replaced each other,and only eGFRcr-cys showed strong correlation with the other three equations.Conclusion As compared with others,eGFR (CKD-EPI-Creat + CysC) is more precise in estimating GFR and evaluating the renal graft loss risk.