PMID- 30357600 OWN - NLM STAT- MEDLINE DCOM- 20190429 LR - 20200225 IS - 1573-2584 (Electronic) IS - 0301-1623 (Linking) VI - 51 IP - 1 DP - 2019 Jan TI - A comparison between 2017 FAS and 2012 CKD-EPI equations: a multi-center validation study in Chinese adult population. PG - 139-146 LID - 10.1007/s11255-018-1997-4 [doi] AB - BACKGROUND: The recent guidelines recommend using the estimated glomerular filtration rate (eGFR) to evaluate renal function. There are two reported full-age-spectrum (FAS) equations in 2017, which are based on serum cystatin C concentrations with or without accompanying serum creatinine level (FAS(Cr-Cys) or FAS(Cys)). We compared the performance and assessed the applicability of the new FAS equation with the 2012 CKD-EPI (CKD-EPI(Cys) and CKD-EPI(Cr-Cys)) equation in Chinese subjects. METHODS: A total of 1184 patients, mean aged 55.06 year who underwent (99m)Tc-DTPA GFR measurements (rGFR) from four hospitals were enrolled. The bias (eGFR-rGFR), precision (interquartile range of difference [IQR]), and accuracy (the proportion of eGFR within 30% of rGFR [P30]) of eGFR and rGFR calculated by four equations were compared. RESULTS: Generally, the equation based on the combination of Cys and Scr performed superior to that on the basis of Cys alone, either the CKD-EPI(Cr-Cys) or the FAS(Cr-Cys). Detailedly, referred to rGFR (67.33 ml/min/1.73 m(2)), the CKD-EPI(Cys), CKD-EPI(Cr-Cys), FAS(Cys), and the FAS(Cr-Cys) estimated GFR 56.46 ml/min/1.73 m(2), 62.79 ml/min/1.73 m(2), 56.45 ml/min/1.73 m(2), and 61.04 ml/min/1.73 m(2), gave ROC(AUC)0.944, 0.954, 0.943, and 0.953, respectively. Another comparison as to bias, precision, P(30), and RMSE with FAS(Cr-Cys) were - 2.87 ml/min/1.73 m(2), 19.01 ml/min/1.73 m(2), 74.16%, and 17.84 ml/min/1.73 m(2) showed that FAS(Cr-Cys) performed approximately more accurate than other equations, as well as the diagnostic consistency of GFR staging. In the rGFR < 60 ml/min/1.73 m(2) subgroup, the FAS(Cr-Cys) equation showed the best performance. In older subjects, compared with FAS(Cys), CKD-EPI(Cr-Cys), and CKD-EPI(Cys), the FAS(Cr-Cys) equation had relatively less bias (- 8.09 vs. - 9.63, - 7.52, - 11.04, P < 0.05), most precise (15.18 vs. 16.32, 15.22, 16.63), and most accuracy, P(30) was statistically different from the other equations, and achieved a ideal value > 70%. CONCLUSION: The performance of the FAS(Cr-Cys) equation is better than that of the CKD-EPI(Cr-Cys) equation in the Chinese population, particularly in the elderly. Yet, further modification of FAS equations from a large-scale study could be more suitable for the Chinese population, particularly in older people. FAU - Yong, Zhenzhu AU - Yong Z AD - Department of Geriatric Nephrology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, People's Republic of China. FAU - Li, Fen AU - Li F AD - Department of Geriatric Nephrology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, People's Republic of China. FAU - Pei, Xiaohua AU - Pei X AD - Department of Geriatric Nephrology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, People's Republic of China. FAU - Liu, Xun AU - Liu X AD - Department of Nephrology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China. FAU - Song, Dan AU - Song D AD - Department of Nephrology, The Affiliated Wuxi No. 2 Hospital of Nanjing Medical University, Wuxi, People's Republic of China. FAU - Zhang, Xiaoxuan AU - Zhang X AD - Department of Nephrology, The Fourth Affiliated Hospital of Jilin University, Changchun, People's Republic of China. FAU - Zhao, Weihong AU - Zhao W AD - Department of Geriatric Nephrology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, People's Republic of China. zhaoweihongny@njmu.edu.cn. LA - eng GR - H0511-81670677/the National Natural Science Foundation of China/ GR - ZDXKA2016003/Jiangsu Provincial Key Discipline of Medicine/ GR - ZDRCA2016021/Jiangsu Provincial Key Laboratory of Geriatrics, Jiangsu Province's Key Medical Talents Program/ GR - BRA2017409/Jiangsu Province 333 Project/ GR - 15020020590/Clinical Medicine Research Special Funds of Chinese Medical Association/ GR - QNRC2016592/Jiangsu Province's Key Medical Young Talents Program/ GR - BJ16016/Jiangsu cadres health care research/ GR - BJ17018/Jiangsu cadres health care research/ PT - Journal Article PT - Multicenter Study PT - Validation Study DEP - 20181024 PL - Netherlands TA - Int Urol Nephrol JT - International urology and nephrology JID - 0262521 RN - 0 (Cystatin C) RN - 0 (Radiopharmaceuticals) RN - AYI8EX34EU (Creatinine) RN - VW78417PU1 (Technetium Tc 99m Pentetate) SB - IM MH - Age Factors MH - Aged MH - China/epidemiology MH - Creatinine/*blood MH - Cystatin C/*blood MH - Dimensional Measurement Accuracy MH - Female MH - *Glomerular Filtration Rate MH - Humans MH - *Kidney Function Tests/methods/statistics & numerical data MH - Male MH - Middle Aged MH - Radiopharmaceuticals/pharmacology MH - *Renal Insufficiency, Chronic/blood/diagnosis/epidemiology MH - Statistics as Topic/methods MH - Technetium Tc 99m Pentetate/pharmacology OTO - NOTNLM OT - Creatinine OT - Cystatin C OT - Estimating equation OT - Full-age-spectrum OT - Glomerular filtration rate (GFR) EDAT- 2018/10/26 06:00 MHDA- 2019/04/30 06:00 CRDT- 2018/10/26 06:00 PHST- 2018/06/17 00:00 [received] PHST- 2018/09/24 00:00 [accepted] PHST- 2018/10/26 06:00 [pubmed] PHST- 2019/04/30 06:00 [medline] PHST- 2018/10/26 06:00 [entrez] AID - 10.1007/s11255-018-1997-4 [pii] AID - 10.1007/s11255-018-1997-4 [doi] PST - ppublish SO - Int Urol Nephrol. 2019 Jan;51(1):139-146. doi: 10.1007/s11255-018-1997-4. Epub 2018 Oct 24.