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Estimating Glomerular Filtration Rate from Serum Myo-Inositol, Valine, Creatinine and Cystatin C

Abstract : Assessment of renal function relies on the estimation of the glomerular filtration rate (eGFR). Existing eGFR equations, usually based on serum levels of creatinine and/or cystatin C, are not uniformly accurate across patient populations. In the present study, we expanded a recent proof-of-concept approach to optimize an eGFR equation targeting the adult population with and without chronic kidney disease (CKD), based on a nuclear magnetic resonance spectroscopy (NMR) derived 'metabolite constellation' (GFR(NMR)). A total of 1855 serum samples were partitioned into development, internal validation and external validation datasets. The new GFR(NMR) equation used serum myo-inositol, valine, creatinine and cystatin C plus age and sex. GFR(NMR) had a lower bias to tracer measured GFR (mGFR) than existing eGFR equations, with a median bias (95% confidence interval [CI]) of 0.0 (-1.0; 1.0) mL/min/1.73 m(2) for GFR(NMR) vs. -6.0 (-7.0; -5.0) mL/min/1.73 m(2) for the Chronic Kidney Disease Epidemiology Collaboration equation that combines creatinine and cystatin C (CKD-EPI(2012)) (p \textless 0.0001). Accuracy (95% CI) within 15% of mGFR (1-P15) was 38.8% (34.3; 42.5) for GFR(NMR) vs. 47.3% (43.2; 51.5) for CKD-EPI(2012) (p \textless 0.010). Thus, GFR(NMR) holds promise as an alternative way to assess eGFR with superior accuracy in adult patients with and without CKD.
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Submitted on : Monday, February 21, 2022 - 8:00:35 AM
Last modification on : Friday, September 30, 2022 - 10:58:10 AM
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F. Stämmler, M. Grassi, J. W. Meeusen, J. C. Lieske, S. Dasari, et al.. Estimating Glomerular Filtration Rate from Serum Myo-Inositol, Valine, Creatinine and Cystatin C. Diagnostics, MDPI, 2021, 11 (12), pp.2291. ⟨10.3390/diagnostics11122291⟩. ⟨inserm-03582043⟩

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