Factors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin C in patients with rheumatoid arthritis

Abstract This study aimed to clarify the factors underlying the discrepancy that has been noted between estimated glomerular filtration ratio (eGFR) measured using serum creatinine (Cr) and eGFR using serum cystatin C (CysC) in patients with rheumatoid arthritis (RA) and to identify those patients w...

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Autores principales:	Akikatsu Nakashima, Shigeto Horita, Takahiro Matsunaga, Ryo Inoue, Takeshi Zoshima, Ichiro Mizushima, Satoshi Hara, Kiyoaki Ito, Hiroshi Fujii, Hideki Nomura, Mitsuhiro Kawano
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d6e5c2b907fb4249a670be8bdd3b1c40
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spelling	oai:doaj.org-article:d6e5c2b907fb4249a670be8bdd3b1c402021-12-02T17:02:21ZFactors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin C in patients with rheumatoid arthritis10.1038/s41598-021-89303-32045-2322https://doaj.org/article/d6e5c2b907fb4249a670be8bdd3b1c402021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-89303-3https://doaj.org/toc/2045-2322Abstract This study aimed to clarify the factors underlying the discrepancy that has been noted between estimated glomerular filtration ratio (eGFR) measured using serum creatinine (Cr) and eGFR using serum cystatin C (CysC) in patients with rheumatoid arthritis (RA) and to identify those patients whose renal function should be evaluated using CysC. We retrospectively evaluated clinical features, disease activity, Steinbrocker radiological staging, and co-morbidities (diabetes mellitus, hypertension, dyslipidemia) in 238 RA patients. eGFR using serum creatinine (eGFR-Cr) and eGFR using serum cystatin C (eGFR-CysC) were calculated using the new Japanese coefficient-modified Modification of Diet in Renal Disease study equation. To clarify the cause(s) of differences of 20% or more between the two eGFRs, we divided our RA patients into Group A (eGFR-Cr/eGFR-CysC ≥ 1.2) and Group B (eGFR-Cr/eGFR-CysC < 1.2), and searched for factors independently related to Group A. Forty-five patients (18.9%) were assigned to Group A, and 193 (81.1%) to Group B. BMI (Odds Ratio [OR] 0.820, 95% confidence interval [CI] 0.675–0.996), Hb (OR 0.633, 95% CI 0.433–0.926), CK (OR 0.773 per 10 units, 95% CI 0.644–0.933), NSAID use (OR 0.099, 95% CI 0.020–0.494), diabetes mellitus (OR 6.024, 95% CI 1.508–24.390) and stage 4 Steinbrocker radiological stage (OR 10.309, 95% CI 2.994–35.714) were identified as independent relevant factors for Group A by a multifactorial analysis. Renal function in RA patients with low BMI, diabetes, anemia and low CK may be overestimated using eGFR-Cr alone, and such patients need to be evaluated using eGFR-CysC.Akikatsu NakashimaShigeto HoritaTakahiro MatsunagaRyo InoueTakeshi ZoshimaIchiro MizushimaSatoshi HaraKiyoaki ItoHiroshi FujiiHideki NomuraMitsuhiro KawanoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Akikatsu Nakashima Shigeto Horita Takahiro Matsunaga Ryo Inoue Takeshi Zoshima Ichiro Mizushima Satoshi Hara Kiyoaki Ito Hiroshi Fujii Hideki Nomura Mitsuhiro Kawano Factors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin C in patients with rheumatoid arthritis
description	Abstract This study aimed to clarify the factors underlying the discrepancy that has been noted between estimated glomerular filtration ratio (eGFR) measured using serum creatinine (Cr) and eGFR using serum cystatin C (CysC) in patients with rheumatoid arthritis (RA) and to identify those patients whose renal function should be evaluated using CysC. We retrospectively evaluated clinical features, disease activity, Steinbrocker radiological staging, and co-morbidities (diabetes mellitus, hypertension, dyslipidemia) in 238 RA patients. eGFR using serum creatinine (eGFR-Cr) and eGFR using serum cystatin C (eGFR-CysC) were calculated using the new Japanese coefficient-modified Modification of Diet in Renal Disease study equation. To clarify the cause(s) of differences of 20% or more between the two eGFRs, we divided our RA patients into Group A (eGFR-Cr/eGFR-CysC ≥ 1.2) and Group B (eGFR-Cr/eGFR-CysC < 1.2), and searched for factors independently related to Group A. Forty-five patients (18.9%) were assigned to Group A, and 193 (81.1%) to Group B. BMI (Odds Ratio [OR] 0.820, 95% confidence interval [CI] 0.675–0.996), Hb (OR 0.633, 95% CI 0.433–0.926), CK (OR 0.773 per 10 units, 95% CI 0.644–0.933), NSAID use (OR 0.099, 95% CI 0.020–0.494), diabetes mellitus (OR 6.024, 95% CI 1.508–24.390) and stage 4 Steinbrocker radiological stage (OR 10.309, 95% CI 2.994–35.714) were identified as independent relevant factors for Group A by a multifactorial analysis. Renal function in RA patients with low BMI, diabetes, anemia and low CK may be overestimated using eGFR-Cr alone, and such patients need to be evaluated using eGFR-CysC.
format	article
author	Akikatsu Nakashima Shigeto Horita Takahiro Matsunaga Ryo Inoue Takeshi Zoshima Ichiro Mizushima Satoshi Hara Kiyoaki Ito Hiroshi Fujii Hideki Nomura Mitsuhiro Kawano
author_facet	Akikatsu Nakashima Shigeto Horita Takahiro Matsunaga Ryo Inoue Takeshi Zoshima Ichiro Mizushima Satoshi Hara Kiyoaki Ito Hiroshi Fujii Hideki Nomura Mitsuhiro Kawano
author_sort	Akikatsu Nakashima
title	Factors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin C in patients with rheumatoid arthritis
title_short	Factors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin C in patients with rheumatoid arthritis
title_full	Factors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin C in patients with rheumatoid arthritis
title_fullStr	Factors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin C in patients with rheumatoid arthritis
title_full_unstemmed	Factors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin C in patients with rheumatoid arthritis
title_sort	factors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin c in patients with rheumatoid arthritis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/d6e5c2b907fb4249a670be8bdd3b1c40
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Factors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin C in patients with rheumatoid arthritis

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