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Extending the cystatin C based EKFC-equation to children - validation results from Europe
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Edité par CCSD -
International audience. BACKGROUND: A new cystatin C based European Kidney Function Consortium (EKFC(CysC)) equation was recently developed for adults, using the same mathematical form as the previously published full age spectrum creatinine based EKFC-equation (EKFC(Crea)). In the present study the cystatin C based EKFC-equation is extended to children, by defining the appropriate cystatin C rescaling factor Q(CysC). METHODS: Rescaling factor Q(CysC) for cystatin C was defined as: a) 0.83 mg/L, exactly as it was defined for young adults in the adult equation, and b) a more complex Q(CysC)-age relationship based on 4(th) degree cystatin C-age polynomials after evaluation of data from Uppsala, Stockholm and Canada and aggregated data from Germany. The EKFC(CysC) equation was then validated in an independent dataset in European children (n = 2,293) with measured GFR, creatinine, cystatin C, age, height and sex available. RESULTS: The EKFC(CysC) with the simple Q(CysC)-value of 0.83 had a bias of -7.6 [95%CI -8.4;-6.5] mL/min/1.73 m(2) and a P30-value of 85.8% [95%CI 84.4;87.3] equal to the EKFC(CysC) with the more complex 4(th) degree Q(CysC)-value. The arithmetic mean of the EKFC(Crea) and EKFC(CysC) with the simple Q(CysC) of 0.83 had a bias of -4.0 [95%CI -4.5;-3.1] mL/min/1.73 m(2) and P30 of 90.4% [95%CI 89.2;91.6] similar to using the more complex 4(th) degree Q(CysC)-polynomial. CONCLUSION: Using exactly the same Q(CysC) of 0.83 mg/L, the adult EKFC(CysC) can easily be extended to children, with some bias but acceptable P30-values. The arithmetic mean of EKFC(Crea) and EKFC(CysC) results in bias closer to zero and P30 slightly over 90%.
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