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Internal and Emergency Medicine
Article . 2024 . Peer-reviewed
License: CC BY
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Other literature type . 2024
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New race-free creatinine- and cystatin C-based equations for the estimation of glomerular filtration rate and association with cardiovascular mortality in the AtheroGene study

Authors: George Ntaios; Jan Brederecke; Francisco M. Ojeda; Tanja Zeller; Stefan Blankenberg; Renate B. Schnabel;

New race-free creatinine- and cystatin C-based equations for the estimation of glomerular filtration rate and association with cardiovascular mortality in the AtheroGene study

Abstract

AbstractRenal function is associated with cardiovascular outcomes and mortality. Among equations used to eGFR, CKD–EPI equations show more accurate association with cardiovascular risk and mortality than MDRD. Recently, new CKD–EPI equations were proposed which do not include race and would be considered sufficiently accurate to estimate eGFR in clinical practice. It is unknown if these new race-free equations are comparably well associated with cardiovascular outcomes in high-risk individuals. The analysis was performed in the AtheroGene Study cohort including patients at high cardiovascular risk. eGFR was determined using the established as well as the recently developed formulas which are calculated without the otherwise existing coefficient for black race. The outcome was cardiovascular death. Analyses included Cox-proportional hazard regression and area-under-the-curve calculation. The analysis included 2089 patients followed up for a median of 3.8 years with a maximum of 6.9 years, corresponding to an overall period of 7701 patient-years. Cardiovascular death occurred in 93 (4.45%), corresponding to an annualized rate of 1.2/100 person-years. In all Cox regression analyses, the estimated adjusted GFR was an independent predictor of cardiovascular death. The equations which included cystatin C showed higher C-index compared to those which did not include cystatin C (0.75–0.76 vs. 0.71, respectively). The equations for the estimation of eGFR which include cystatin C are better associated with cardiovascular death compared to the race-free equations which include only creatinine. This finding adds on the related literature which supports the elimination of race in GFR-estimating equations, and promotion of the use of cystatin C.

Keywords

Male, Female [MeSH] ; Aged [MeSH] ; Biomarkers/blood [MeSH] ; Humans [MeSH] ; Middle Aged [MeSH] ; Cystatin C/blood [MeSH] ; Im - Original ; Prediction ; Glomerular Filtration Rate [MeSH] ; Estimated glomerular filtration rate ; Proportional Hazards Models [MeSH] ; Mortality ; Male [MeSH] ; Creatinine/blood [MeSH] ; Estimation of renal function ; Cardiovascular Diseases/mortality [MeSH] ; Cardiovascular death, Middle Aged, Im - Original, Cardiovascular Diseases, Creatinine, Humans, Female, Cystatin C, Biomarkers, Glomerular Filtration Rate, Aged, Proportional Hazards Models

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
Green
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