Cystatin C is better than serum creatinine for estimating glomerular filtration rate to detect osteopenia in chronic kidney disease patients

Young Eun Kwon, Mi Jung Lee, Kyoung Sook Park, SeungHyeok Han, TaeHyun Yoo, Kook Hwan Oh, Joongyub Lee, Kyu Beck Lee, Wookyung Chung, Yeong Hoon Kim, Curie Ahn, Kyu Hun Choi

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: Recent studies have reported that loss of bone mass is associated with renal function decline and increased fracture risks in chronic kidney disease (CKD) patients. The aim of this study was to investigate the best estimated glomerular filtration rate (eGFR) equation to detect osteopenia in CKD patients. Materials and Methods: This was a cross-sectional study, and 780 patients aged 50 years or above were classified into normal bone mass or osteopenia groups according to the -1.0 of T-scores at total hip and femur neck. Comparisons of area under the receiver operating characteristic (ROC) curves (AUC) were performed to investigate significant differences among three eGFR formulas: Modification of Diet in Renal Disease, CKD-Epidemiology Collaboration (EPI) creatinine, and CKD-EPI cystatin C (CKD-EPICys). Results: The mean age was 61 years old and the proportion of females was 37.3%. The total hip osteopenia group showed lower CKD-EPI-Cys eGFR levels (osteopenia group, 33.3±19.0 mL/min/1.73 m2; normal group, 48.1±26.2 mL/min/1.73 m2, p<0.001). In multiple logistic regression analysis, CKD-EPI-Cys eGFR was independently associated with osteopenia at the total hip (per 1 mL/min/1.73 m2 increase, odds ratio 0.98, 95% confidence interval 0.97–0.99, p=0.004) after adjusting for confounding variables. ROC curve analyses indicated that CKD-EPI-Cys shows the largest AUC for osteopenia at the total hip (AUC=0.678, all p<0.01) and the femur neck (AUC=0.665, all p<0.05). Conclusion: Decreased renal function assessed by CKD-EPI-Cys equation correlates with osteopenia better than creatininebased methods in CKD patients, and the CKD-EPI-Cys formula might be a useful tool to assess skeletal-related event risks.

Original languageEnglish
Pages (from-to)380-387
Number of pages8
JournalYonsei medical journal
Volume58
Issue number2
DOIs
Publication statusPublished - 2017 Mar 1

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Cystatin C
Metabolic Bone Diseases
Glomerular Filtration Rate
Chronic Renal Insufficiency
Creatinine
Epidemiology
Serum
Area Under Curve
Hip
Femur Neck
Kidney
ROC Curve
Formulated Food
Bone and Bones
Confounding Factors (Epidemiology)
Cross-Sectional Studies
Logistic Models
Odds Ratio
Regression Analysis
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Kwon, Young Eun ; Lee, Mi Jung ; Park, Kyoung Sook ; Han, SeungHyeok ; Yoo, TaeHyun ; Oh, Kook Hwan ; Lee, Joongyub ; Lee, Kyu Beck ; Chung, Wookyung ; Kim, Yeong Hoon ; Ahn, Curie ; Choi, Kyu Hun. / Cystatin C is better than serum creatinine for estimating glomerular filtration rate to detect osteopenia in chronic kidney disease patients. In: Yonsei medical journal. 2017 ; Vol. 58, No. 2. pp. 380-387.
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abstract = "Purpose: Recent studies have reported that loss of bone mass is associated with renal function decline and increased fracture risks in chronic kidney disease (CKD) patients. The aim of this study was to investigate the best estimated glomerular filtration rate (eGFR) equation to detect osteopenia in CKD patients. Materials and Methods: This was a cross-sectional study, and 780 patients aged 50 years or above were classified into normal bone mass or osteopenia groups according to the -1.0 of T-scores at total hip and femur neck. Comparisons of area under the receiver operating characteristic (ROC) curves (AUC) were performed to investigate significant differences among three eGFR formulas: Modification of Diet in Renal Disease, CKD-Epidemiology Collaboration (EPI) creatinine, and CKD-EPI cystatin C (CKD-EPICys). Results: The mean age was 61 years old and the proportion of females was 37.3{\%}. The total hip osteopenia group showed lower CKD-EPI-Cys eGFR levels (osteopenia group, 33.3±19.0 mL/min/1.73 m2; normal group, 48.1±26.2 mL/min/1.73 m2, p<0.001). In multiple logistic regression analysis, CKD-EPI-Cys eGFR was independently associated with osteopenia at the total hip (per 1 mL/min/1.73 m2 increase, odds ratio 0.98, 95{\%} confidence interval 0.97–0.99, p=0.004) after adjusting for confounding variables. ROC curve analyses indicated that CKD-EPI-Cys shows the largest AUC for osteopenia at the total hip (AUC=0.678, all p<0.01) and the femur neck (AUC=0.665, all p<0.05). Conclusion: Decreased renal function assessed by CKD-EPI-Cys equation correlates with osteopenia better than creatininebased methods in CKD patients, and the CKD-EPI-Cys formula might be a useful tool to assess skeletal-related event risks.",
author = "Kwon, {Young Eun} and Lee, {Mi Jung} and Park, {Kyoung Sook} and SeungHyeok Han and TaeHyun Yoo and Oh, {Kook Hwan} and Joongyub Lee and Lee, {Kyu Beck} and Wookyung Chung and Kim, {Yeong Hoon} and Curie Ahn and Choi, {Kyu Hun}",
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Cystatin C is better than serum creatinine for estimating glomerular filtration rate to detect osteopenia in chronic kidney disease patients. / Kwon, Young Eun; Lee, Mi Jung; Park, Kyoung Sook; Han, SeungHyeok; Yoo, TaeHyun; Oh, Kook Hwan; Lee, Joongyub; Lee, Kyu Beck; Chung, Wookyung; Kim, Yeong Hoon; Ahn, Curie; Choi, Kyu Hun.

In: Yonsei medical journal, Vol. 58, No. 2, 01.03.2017, p. 380-387.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cystatin C is better than serum creatinine for estimating glomerular filtration rate to detect osteopenia in chronic kidney disease patients

AU - Kwon, Young Eun

AU - Lee, Mi Jung

AU - Park, Kyoung Sook

AU - Han, SeungHyeok

AU - Yoo, TaeHyun

AU - Oh, Kook Hwan

AU - Lee, Joongyub

AU - Lee, Kyu Beck

AU - Chung, Wookyung

AU - Kim, Yeong Hoon

AU - Ahn, Curie

AU - Choi, Kyu Hun

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Purpose: Recent studies have reported that loss of bone mass is associated with renal function decline and increased fracture risks in chronic kidney disease (CKD) patients. The aim of this study was to investigate the best estimated glomerular filtration rate (eGFR) equation to detect osteopenia in CKD patients. Materials and Methods: This was a cross-sectional study, and 780 patients aged 50 years or above were classified into normal bone mass or osteopenia groups according to the -1.0 of T-scores at total hip and femur neck. Comparisons of area under the receiver operating characteristic (ROC) curves (AUC) were performed to investigate significant differences among three eGFR formulas: Modification of Diet in Renal Disease, CKD-Epidemiology Collaboration (EPI) creatinine, and CKD-EPI cystatin C (CKD-EPICys). Results: The mean age was 61 years old and the proportion of females was 37.3%. The total hip osteopenia group showed lower CKD-EPI-Cys eGFR levels (osteopenia group, 33.3±19.0 mL/min/1.73 m2; normal group, 48.1±26.2 mL/min/1.73 m2, p<0.001). In multiple logistic regression analysis, CKD-EPI-Cys eGFR was independently associated with osteopenia at the total hip (per 1 mL/min/1.73 m2 increase, odds ratio 0.98, 95% confidence interval 0.97–0.99, p=0.004) after adjusting for confounding variables. ROC curve analyses indicated that CKD-EPI-Cys shows the largest AUC for osteopenia at the total hip (AUC=0.678, all p<0.01) and the femur neck (AUC=0.665, all p<0.05). Conclusion: Decreased renal function assessed by CKD-EPI-Cys equation correlates with osteopenia better than creatininebased methods in CKD patients, and the CKD-EPI-Cys formula might be a useful tool to assess skeletal-related event risks.

AB - Purpose: Recent studies have reported that loss of bone mass is associated with renal function decline and increased fracture risks in chronic kidney disease (CKD) patients. The aim of this study was to investigate the best estimated glomerular filtration rate (eGFR) equation to detect osteopenia in CKD patients. Materials and Methods: This was a cross-sectional study, and 780 patients aged 50 years or above were classified into normal bone mass or osteopenia groups according to the -1.0 of T-scores at total hip and femur neck. Comparisons of area under the receiver operating characteristic (ROC) curves (AUC) were performed to investigate significant differences among three eGFR formulas: Modification of Diet in Renal Disease, CKD-Epidemiology Collaboration (EPI) creatinine, and CKD-EPI cystatin C (CKD-EPICys). Results: The mean age was 61 years old and the proportion of females was 37.3%. The total hip osteopenia group showed lower CKD-EPI-Cys eGFR levels (osteopenia group, 33.3±19.0 mL/min/1.73 m2; normal group, 48.1±26.2 mL/min/1.73 m2, p<0.001). In multiple logistic regression analysis, CKD-EPI-Cys eGFR was independently associated with osteopenia at the total hip (per 1 mL/min/1.73 m2 increase, odds ratio 0.98, 95% confidence interval 0.97–0.99, p=0.004) after adjusting for confounding variables. ROC curve analyses indicated that CKD-EPI-Cys shows the largest AUC for osteopenia at the total hip (AUC=0.678, all p<0.01) and the femur neck (AUC=0.665, all p<0.05). Conclusion: Decreased renal function assessed by CKD-EPI-Cys equation correlates with osteopenia better than creatininebased methods in CKD patients, and the CKD-EPI-Cys formula might be a useful tool to assess skeletal-related event risks.

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