ArticleClinical kidney journal2026
Glomerular filtration rate estimation in nephrotic patients: creatinine and/or cystatin-C-based equations, or none of them?
Article in Clinical kidney journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The performance of serum-creatinine- and/or cystatin-C-based chronic kidney disease -Epidemiology (CKD-Epi) Collaboration and European Kidney Function Consortium (EKFC) glomerular filtration rate (GFR) estimates (creatinine-based GFR estimates (eGFRcr), cystatin-C-based GFR estimates (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 1-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 ( 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.
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