Mp52-02 cystatin c is more sensitive than creatinine in detection of kidney dysfunction in non-weight-bearing individuals

You have accessJournal of UrologyCME1 Apr 2023MP52-02 CYSTATIN C IS MORE SENSITIVE THAN CREATININE IN DETECTION OF KIDNEY DYSFUNCTION IN NON-WEIGHT-BEARING INDIVIDUALS Glenn Werneburg, Daniel Hettel, Stacy Jeong, Gregory Nemunaitis, Jonathan Taliercio, and Hadley Wood Glenn WerneburgGlenn Werneburg More articles by this author , Daniel HettelDaniel Hettel More articles by this author , Stacy JeongStacy Jeong More articles by this author , Gregory NemunaitisGregory Nemunaitis More articles by this author , Jonathan TaliercioJonathan Taliercio More articles by this author , and Hadley WoodHadley Wood More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003300.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Individuals with neurological disorders and neurogenic lower urinary tract dysfunction are often non-weight-bearing (NWB) with lower muscle mass than the general population. We sought to compare eGFR equations that include creatinine, cystatin C, or both, in NWB individuals and matched ambulatory controls. METHODS: Electronic medical records were reviewed for individuals with serum creatinine (Cr) and cystatin C (cys) and diagnosis consistent with NWB status, and ambulatory controls matched by age, race, sex, kidney function, diabetes, and hypertension. 2021 CKD-EPI race agnostic equations were used to calculate eGFR. Demographics and renal function were compared in the overall cohorts and in a patient subset with imaging and/or urinalysis evidence of renal dysfunction. Patients who were classified into a new eGFR category based on the incorporation of cystatin C were determined. eGFR classifications reflected those used in chronic kidney disease staging: CKD stage 1 ≥90 mL/min/1.73 m2, CKD stage 2 60-89 mL/min/1.73 m2, CKD stage 3 30-59 mL/min/1.73 m2, CKD stage 4 15-29 mL/min/1.73 m2, and CKD stage 5 <15 mL/min/1.73 m2. RESULTS: In the NWB population (n=102), eGFR differed significantly when calculated using CKD-EPICr, CKD-EPICr+Cys and CKD-EPICys (107, 93, 80 mL/min/1.73 m2, respectively, p<0.001). The differences in eGFR were greater in the NWB group relative to the control group (n=204) regardless of CKD-EPI equation pairs compared (p<0.001, Table 1). In the patient subset with imaging and/or proteinuria evidence of renal dysfunction, the NWB population again had different eGFR when calculated using the CKD-EPICr, CKD-EPICr+Cys and CKD-EPICys equations (102, 86, 71 mL/min/1.73 m2, respectively, p<0.001). Fifty-eight percent of NWB individuals with evidence of renal dysfunction on imaging or urinalysis were reclassified into a category of lower eGFR (corresponding to CKD stage) when using eGFRCys relative to eGFRCr. CONCLUSIONS: eGFR equations containing serum creatinine, cystatin C, or both, validated in mostly ambulatory populations, are not equivalently accurate in estimating kidney function in NWB individuals. Comparison of these equations against gold standard GFR measurement is needed to determine which most closely approximates true GFR. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e702 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Glenn Werneburg More articles by this author Daniel Hettel More articles by this author Stacy Jeong More articles by this author Gregory Nemunaitis More articles by this author Jonathan Taliercio More articles by this author Hadley Wood More articles by this author Expand All Advertisement PDF downloadLoading ...