PMID- 28484878
OWN - NLM
STAT- MEDLINE
DCOM- 20180402
LR  - 20181128
IS  - 1432-198X (Electronic)
IS  - 0931-041X (Linking)
VI  - 32
IP  - 8
DP  - 2017 Aug
TI  - The association between creatinine versus cystatin C-based eGFR and 
      cardiovascular risk in children with chronic kidney disease using a modified PDAY 
      risk score.
PG  - 1457-1463
LID - 10.1007/s00467-017-3683-7 [doi]
AB  - BACKGROUND: Children with chronic kidney disease (CKD) have a high prevalence of 
      cardiovascular disease (CVD) risk factors which may contribute to the development 
      of cardiovascular events in adulthood. Among adults with CKD, cystatin C-based 
      estimates of glomerular filtration rate (eGFR) demonstrate a stronger predictive 
      value for cardiovascular events than creatinine-based eGFR. The PDAY 
      (Pathobiological Determinants of Atherosclerosis in Youth) risk score is a 
      validated tool used to estimate the probability of advanced coronary 
      atherosclerotic lesions in young adults. OBJECTIVE: To assess the association 
      between cystatin C-based versus creatinine-based eGFR (eGFR cystatin C and eGFR 
      creatinine, respectively) and cardiovascular risk using a modified PDAY risk 
      score as a proxy for CVD in children and young adults. METHODS: We performed a 
      cross-sectional study of 71 participants with CKD [median age 15.5 years; 
      inter-quartile range (IQR) 13, 17], and 33 healthy controls (median age 15.1 
      years; IQR 13, 17). eGFR was calculated using age-appropriate creatinine- and 
      cystatin C-based formulas. Median eGFR creatinine and eGFR cystatin C for CKD 
      participants were 50 (IQR 30, 75) and 53 (32, 74) mL/min/1.73 m(2), respectively. 
      For the healthy controls, median eGFR creatinine and eGFR cystatin were 112 (IQR 
      85, 128) and 106 mL/min/1.73m(2) (95, 123) mL/min/1.73 m(2), respectively. A 
      modified PDAY risk score was calculated based on sex, age, serum lipoprotein 
      concentrations, obesity, smoking status, hypertension, and hyperglycemia. 
      RESULTS: Modified PDAY scores ranged from -2 to 20. The Spearman's correlations 
      of eGFR creatinine and eGFR cystatin C with coronary artery PDAY scores were 
      -0.23 (p = 0.02) and -0.28 (p = 0.004), respectively. Ordinal logistic regression 
      also showed a similar association of higher eGFR creatinine and higher eGFR 
      cystatin C with lower PDAY scores. When stratified by age <18 or >/=18 years, the 
      correlations of eGFR creatinine and eGFR cystatin C with PDAY score were modest 
      and similar in children [-0.29 (p = 0.008) vs. -0.32 (p = 0.004), respectively]. 
      Despite a smaller sample size, the correlation in adults was stronger for eGFR 
      cystatin C (-0.57; p = 0.006) than for eGFR creatinine (-0.40; p = 0.07). 
      CONCLUSIONS: Overall, the correlation between cystatin C- or creatinine-based 
      eGFR with PDAY risk score was similar in children. Further studies in children 
      with CKD should explore the association between cystatin C and cardiovascular 
      risk.
FAU - Sharma, Sheena
AU  - Sharma S
AUID- ORCID: 0000-0002-2316-8725
AD  - Division of Nephrology, Phoenix Children's Hospital, 1919 E Thomas Road, Building 
      E, Suite 200, Phoenix, AZ, 85016, USA. ssharma@phoenixchildrens.com.
FAU - Denburg, Michelle R
AU  - Denburg MR
AD  - Division of Nephrology, The Children's Hospital of Philadelphia, Philadelphia, 
      PA, USA.
AD  - Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 
      USA.
FAU - Furth, Susan L
AU  - Furth SL
AD  - Division of Nephrology, The Children's Hospital of Philadelphia, Philadelphia, 
      PA, USA.
AD  - Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 
      USA.
LA  - eng
GR  - K23 DK093556/DK/NIDDK NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
DEP - 20170508
PL  - Germany
TA  - Pediatr Nephrol
JT  - Pediatric nephrology (Berlin, Germany)
JID - 8708728
RN  - 0 (CST3 protein, human)
RN  - 0 (Cystatin C)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adolescent
MH  - Atherosclerosis/*epidemiology/etiology
MH  - Child
MH  - Creatinine/*blood
MH  - Cross-Sectional Studies
MH  - Cystatin C/*blood
MH  - Female
MH  - *Glomerular Filtration Rate
MH  - Humans
MH  - Kidney Function Tests
MH  - Male
MH  - Prevalence
MH  - Renal Insufficiency, Chronic/*blood/complications
MH  - Risk Factors
OTO - NOTNLM
OT  - Cardiovascular disease
OT  - Cardiovascular risk
OT  - Chronic kidney disease
OT  - PDAY
OT  - Pathobiological Determinants of Atherosclerosis in Youth
EDAT- 2017/05/10 06:00
MHDA- 2018/04/03 06:00
CRDT- 2017/05/10 06:00
PHST- 2016/09/21 00:00 [received]
PHST- 2017/04/18 00:00 [accepted]
PHST- 2017/04/16 00:00 [revised]
PHST- 2017/05/10 06:00 [pubmed]
PHST- 2018/04/03 06:00 [medline]
PHST- 2017/05/10 06:00 [entrez]
AID - 10.1007/s00467-017-3683-7 [pii]
AID - 10.1007/s00467-017-3683-7 [doi]
PST - ppublish
SO  - Pediatr Nephrol. 2017 Aug;32(8):1457-1463. doi: 10.1007/s00467-017-3683-7. Epub 
      2017 May 8.