GFR estimation in nephrotic patients: creatinine and/or cystatin-C based equations, or none of them?
Clicks: 13
ID: 327202
2026
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This
article has not been analysed, so there is no overall score —
reader engagement is measured and shown alongside.
Reader Engagement
Emerging Content
3.6
/100
13 views
12 readers
AI Quality Assessment
Not analyzed
Readership in this journal
EmergingRanked #53 of 153 articles by views in clinical kidney journal
Most read
Least read
Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 153 in total.
Mint this article as an NFT
Not yet mintedCreate a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.
5
SUSD
one-off · no wallet required
Abstract
Abstract Background The performance of serum creatinine and/or cystatin-c-based CKD-Epidemiology (CKD-Epi) Collaboration and European-Kidney-Function-Consortium (EKFC) GFR estimates (eGFRcr, eGFRcys and eGFRcr + cys, respectively) in nephrotic patients with CKD is unknown. Methods We retrospectively evaluated the performance of all the six aforementioned equations in 100 blood samples collected one-year apart from 50 consenting patients with primary Membranous Nephropathy (MN) and proteinuria > 3.5 g/24-h who had their GFR simultaneously measured with the iohexol plasma clearance technique during three intervention studies. The study had > 85% power to detect a significant difference between actual and reference (0.90) concordance correlation coefficient (CCC). Results With CKD-Epi and EKFC, eGFRcr values overestimated, whereas eGFRcys values underestimated (P < 0.001 for all) mGFR. eGFRcr + cys bias was significant (P < 0.05) in hypo-albuminemic participants. Biases significantly increased with worsening hypoalbuminemia, but independently of proteinuria. In normo-albuminemic participants, CCC did not differ from the 0.90 reference value and total deviation index (TDI) was < 30 only with CKD Epi and EKFC eGFRcr + cys equations. The error exceeded 10% in > 40% of estimates. Over one year, mGFR increased by 4.8 ml/min/1.73m2 (P = 0.008). This change was not captured by any equation. Conclusions The performance of GFR estimation equations is acceptable only when creatinine and cystatin-c are simultaneously used as filtration markers in nephrotic patients without hypoalbuminemia. Direct GFR measurement is needed for accurate kidney function evaluation in those with hypoalbuminemia, and whenever individual clinical decision makings (including dosing of toxic medications with renal clearance) or evaluations of treatment effects on GFR changes over time are needed in clinics or research.
| Reference Key |
openalex_W7204848446
Use this key to autocite in the manuscript while using
SciMatic Manuscript Manager or Thesis Manager
|
|---|---|
| Authors | Fabiola Carrara, Serenella Valaperta, Mariagrazia Alessio, Matias Trillini, Alessia Gennarini, Aura Crispino, Alessandro Villa, Tobia Peracchi, Daniela Cugini, Nadia Stucchi, Ilaria Pagani, Giuseppe Remuzzi, Piero Ruggenenti |
| Journal | clinical kidney journal |
| Year | 2026 |
| DOI |
10.1093/ckj/sfag256
|
| URL | |
| Keywords | Keywords not found |
Citations
No citations found. To add a citation, contact the admin at info@scimatic.org
Comments
No comments yet. Be the first to comment on this article.