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Creatinine- versus cystatin C-based renal function assessment in the Northern Manhattan Study.

Publication ,  Journal Article
Husain, SA; Willey, JZ; Park Moon, Y; Elkind, MSV; Sacco, RL; Wolf, M; Cheung, K; Wright, CB; Mohan, S
Published in: PLoS One
2018

BACKGROUND: Accurate glomerular filtration rate estimation informs drug dosing and risk stratification. Body composition heterogeneity influences creatinine production and the precision of creatinine-based estimated glomerular filtration rate (eGFRcr) in the elderly. We compared chronic kidney disease (CKD) categorization using eGFRcr and cystatin C-based estimated GFR (eGFRcys) in an elderly, racially/ethnically diverse cohort to determine their concordance. METHODS: The Northern Manhattan Study (NOMAS) is a predominantly elderly, multi-ethnic cohort with a primary aim to study cardiovascular disease epidemiology. We included participants with concurrently measured creatinine and cystatin C. eGFRcr was calculated using the CKD-EPI 2009 equation. eGFRcys was calculated using the CKD-EPI 2012 equation. Logistic regression was used to estimate odds ratios and 95% confidence intervals of factors associated with reclassification from eGFRcr≥60ml/min/1.73m2 to eGFRcys<60ml/min/1.73m2. RESULTS: Participants (n = 2988, mean age 69±10yrs) were predominantly Hispanic, female, and overweight/obese. eGFRcys was lower than eGFRcr by mean 23mL/min/1.73m2. 51% of participants' CKD status was discordant, and only 28% maintained the same CKD stage by both measures. Most participants (78%) had eGFRcr≥60mL/min/1.73m2; among these, 64% had eGFRcys<60mL/min/1.73m2. Among participants with eGFRcr≥60mL/min/1.73m2, eGFRcys-based reclassification was more likely in those with age >65 years, obesity, current smoking, white race, and female sex. CONCLUSIONS: In a large, multiethnic, elderly cohort, we found a highly discrepant prevalence of CKD with eGFRcys versus eGFRcr. Determining the optimal method to estimate GFR in elderly populations needs urgent further study to improve risk stratification and drug dosing.

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Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2018

Volume

13

Issue

11

Start / End Page

e0206839

Location

United States

Related Subject Headings

  • Risk Assessment
  • Renal Insufficiency, Chronic
  • Prospective Studies
  • Prevalence
  • New York City
  • Middle Aged
  • Male
  • Kidney
  • Humans
  • Glomerular Filtration Rate
 

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Husain, S. A., Willey, J. Z., Park Moon, Y., Elkind, M. S. V., Sacco, R. L., Wolf, M., … Mohan, S. (2018). Creatinine- versus cystatin C-based renal function assessment in the Northern Manhattan Study. PLoS One, 13(11), e0206839. https://doi.org/10.1371/journal.pone.0206839
Husain, S Ali, Joshua Z. Willey, Yeseon Park Moon, Mitchell S. V. Elkind, Ralph L. Sacco, Myles Wolf, Ken Cheung, Clinton B. Wright, and Sumit Mohan. “Creatinine- versus cystatin C-based renal function assessment in the Northern Manhattan Study.PLoS One 13, no. 11 (2018): e0206839. https://doi.org/10.1371/journal.pone.0206839.
Husain SA, Willey JZ, Park Moon Y, Elkind MSV, Sacco RL, Wolf M, et al. Creatinine- versus cystatin C-based renal function assessment in the Northern Manhattan Study. PLoS One. 2018;13(11):e0206839.
Husain, S. Ali, et al. “Creatinine- versus cystatin C-based renal function assessment in the Northern Manhattan Study.PLoS One, vol. 13, no. 11, 2018, p. e0206839. Pubmed, doi:10.1371/journal.pone.0206839.
Husain SA, Willey JZ, Park Moon Y, Elkind MSV, Sacco RL, Wolf M, Cheung K, Wright CB, Mohan S. Creatinine- versus cystatin C-based renal function assessment in the Northern Manhattan Study. PLoS One. 2018;13(11):e0206839.

Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2018

Volume

13

Issue

11

Start / End Page

e0206839

Location

United States

Related Subject Headings

  • Risk Assessment
  • Renal Insufficiency, Chronic
  • Prospective Studies
  • Prevalence
  • New York City
  • Middle Aged
  • Male
  • Kidney
  • Humans
  • Glomerular Filtration Rate