Albuminuria and neck circumference are determinate factors of successful accurate estimation of glomerular filtration rate in high cardiovascular risk patients

• Published in: PloS one Vol. 13; no. 2; p. e0185693
• Main Authors: Hsiao, Po-Jen, Lin, Hung-Che, Chang, Shih-Tai, Hsu, Jen-Te, Lin, Wei-Shiang, Chung, Chang-Min, Chang, Jung-Jung, Hung, Kuo-Chun, Shih, Yun-Wen, Chen, Fu-Chi, Hu, Fu-Kang, Wu, Yi-Syuan, Chang, Chi-Wen, Su, Sui-Lung, Chu, Chi-Ming
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 02-02-2018; Public Library of Science (PLoS)
• Subjects: Albuminuria; Analysis; Bias; Biology and Life Sciences; Cardiac patients; Cardiology; Cardiovascular diseases; Chronic kidney failure; Circumferences; Correlation; Creatinine; Cystatin C; Diabetes; Epidemiology; Epidermal growth factor receptors; Evaluation; Glomerular filtration rate; Health risks; Hospitals; Internal medicine; Kidney diseases; Life sciences; Mathematical models; Medical research; Medicine; Medicine and Health Sciences; Metabolic syndrome; Methods; Mortality; Neck; Nephrology; Patients; Physiological aspects; Predictions; Public health; Regression analysis; Risk factors; Transplants & implants; Urine; Taiwan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0185693

Estimated glomerular filtration rate (eGFR) is used for diagnosis of chronic kidney disease (CKD). The eGFR models based on serum creatinine or cystatin C are used more in clinical practice. Albuminuria and neck circumference are associated with CKD and may have correlations with eGFR.
We explored the correlations and modelling formulates among various indicators such as serum creatinine, cystatin C, albuminuria, and neck circumference for eGFR.
Cross-sectional study.
We reviewed the records of patients with high cardiovascular risk from 2010 to 2011 in Taiwan. 24-hour urine creatinine clearance was used as the standard. We utilized a decision tree to select for variables and adopted a stepwise regression method to generate five models. Model 1 was based on only serum creatinine and was adjusted for age and gender. Model 2 added serum cystatin C, models 3 and 4 added albuminuria and neck circumference, respectively. Model 5 simultaneously added both albuminuria and neck circumference.
Total 177 patients were recruited in this study. In model 1, the bias was 2.01 and its precision was 14.04. In model 2, the bias was reduced to 1.86 with a precision of 13.48. The bias of model 3 was 1.49 with a precision of 12.89, and the bias for model 4 was 1.74 with a precision of 12.97. In model 5, the bias could be lower to 1.40 with a precision of 12.53.
In this study, the predicting ability of eGFR was improved after the addition of serum cystatin C compared to serum creatinine alone. The bias was more significantly reduced by the calculation of albuminuria. Furthermore, the model generated by combined albuminuria and neck circumference could provide the best eGFR predictions among these five eGFR models. Neck circumference can be investigated potentially in the further studies.