Differences in the glomerular filtration rate calculated by two creatinine-based and three cystatin-C-based formulae in hospitalized elderly patients

Nephron Clin Pract. 2008;108(1):c16-22. doi: 10.1159/000112477. Epub 2007 Dec 13.

Abstract

Background: Reduced renal function is a health problem in elderly patients. Different creatinine- and cystatin-C-based formulae have been used to estimate glomerular filtration rate (GFR).

Aims: To investigate individual and group differences of GFR estimates derived from five different formulae.

Methods: 60 patients were randomly assigned to participate in this cross-sectional study. Nutrition status was assessed, blood samples were drawn and GFR was calculated using two creatinine- and three cystatin-C-based formulae.

Results: Four of five formulae indicate reduced GFR in >70% of the participants, GFR was significantly less in malnourished patients according to one creatinine formula. Estimates from the formulae were highly correlated (r = 0.607-0.863, p < 0.001), but individual differences were between -36.1 and 79.9 ml/min/1.73 m(2). The formulae grouped 38.3-60.0% of the subjects differently into the five stages of chronic kidney disease. BMI, total cholesterol, age and gender were significant predictors for the calculated GFR differences between the formulae.

Conclusion: The prevalence of reduced renal function is high in elderly hospitalized patients. BMI, age and/or gender can affect GFR estimates depending on the formula used, and there is an association between total cholesterol and calculated GFR differences between formulae. Different formulae can result in a different grouping of patients into the five stages of chronic renal disease.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Creatinine / metabolism*
  • Cross-Sectional Studies
  • Cystatin C
  • Cystatins / metabolism*
  • Female
  • Glomerular Filtration Rate / physiology*
  • Hospitalization*
  • Humans
  • Male
  • Random Allocation

Substances

  • CST3 protein, human
  • Cystatin C
  • Cystatins
  • Creatinine