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

dc.contributor.author Wolf, Myles
dc.contributor.author Husain, S Ali
dc.contributor.author Willey, Joshua Z
dc.contributor.author Park Moon, Yeseon
dc.contributor.author Elkind, Mitchell SV
dc.contributor.author Sacco, Ralph L
dc.contributor.author Cheung, Ken
dc.contributor.author Wright, Clinton B
dc.contributor.author Mohan, Sumit
dc.date.accessioned 2019-05-01T16:34:30Z
dc.date.available 2019-05-01T16:34:30Z
dc.date.issued 2018-01
dc.identifier PONE-D-18-09465
dc.identifier.issn 1932-6203
dc.identifier.issn 1932-6203
dc.identifier.uri https://hdl.handle.net/10161/18488
dc.description.abstract 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.
dc.language eng
dc.publisher Public Library of Science (PLoS)
dc.relation.ispartof PloS one
dc.relation.isversionof 10.1371/journal.pone.0206839
dc.subject Kidney
dc.subject Humans
dc.subject Creatinine
dc.subject Glomerular Filtration Rate
dc.subject Prevalence
dc.subject Risk Assessment
dc.subject Prospective Studies
dc.subject Age Factors
dc.subject Aged
dc.subject Middle Aged
dc.subject New York City
dc.subject Female
dc.subject Male
dc.subject Renal Insufficiency, Chronic
dc.subject Cystatin C
dc.title Creatinine- versus cystatin C-based renal function assessment in the Northern Manhattan Study.
dc.type Journal article
duke.contributor.id Wolf, Myles|0721663
dc.date.updated 2019-05-01T16:34:29Z
pubs.begin-page e0206839
pubs.issue 11
pubs.organisational-group School of Medicine
pubs.organisational-group Duke
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Population Health Sciences
pubs.organisational-group Basic Science Departments
pubs.organisational-group Medicine, Nephrology
pubs.organisational-group Medicine
pubs.organisational-group Clinical Science Departments
pubs.publication-status Published
pubs.volume 13


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