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Updated: Dec 18, 2025
A High-throughput Method for Measurement of Glomerular Filtration Rate in Conscious Mice
Published on: May 10, 2013
Overestimation of glomerular filtration rate by creatinine-based equation in heart failure patients is predicted by a
Tomoyuki Ishigo1, Satoshi Katano2, Toshiyuki Yano3
1Division of Hospital Pharmacy, Sapporo Medical University Hospital, Sapporo, Japan.
Insights
A new scoring system can predict overestimation of kidney function by creatinine-based estimated glomerular filtration rate (eGFRcre) in heart failure patients. This tool helps identify individuals needing cystatin C-based eGFR for accurate renal function assessment.
Area of Science:
- Nephrology
- Geriatric Medicine
- Cardiology
Background:
- Creatinine-based estimated glomerular filtration rate (eGFRcre) often overestimates actual kidney function in older adults compared to cystatin C-based eGFR (eGFRcys).
- Accurate assessment of glomerular filtration rate (GFR) is crucial, especially in vulnerable populations like heart failure patients.
Purpose of the Study:
- To investigate clinical factors contributing to GFR overestimation by eGFRcre in heart failure patients.
- To develop a predictive score for identifying GFR overestimation (OE) using readily available clinical data.
Main Methods:
- Retrospective analysis of 244 Japanese heart failure patients without extrarenal factors affecting cystatin C.
- Defined GFR overestimation as eGFRcre being ≥120% of eGFRcys.
- Utilized multivariate regression to identify independent predictors of OE.
Main Results:
- 14.3% of patients exhibited GFR overestimation (OE).
- Independent predictors of OE included lower body weight, lower hemoglobin levels, higher blood urea nitrogen-to-creatinine ratio, and reduced skeletal muscle mass.
- A predictive score incorporating body weight, hemoglobin, and BUN/creatinine ratio achieved 97.1% sensitivity and 98.1% specificity for OE.
Conclusions:
- GFR overestimation by eGFRcre is predictable in heart failure patients using a novel scoring system.
- This scoring system may aid in identifying patients who would benefit from cystatin C-based eGFR for precise renal function evaluation.
Aims:
Creatinine-based estimated glomerular filtration rate (eGFRcre) has been shown to overestimate the glomerular filtration rate (GFR) when it is compared with cystatin C-based estimated GFR (eGFRcys) in older people. We investigated clinical determinants of GFR overestimation by eGFRcre and developed a score for prediction of GFR overestimation (OE) in heart failure patients.
Methods:
We retrospectively examined 244 Japanese heart failure patients (aged 72.2 ± 13.1 years; 48% women) who had no known extrarenal factors that affect serum cystatin C concentration. eGFR OE by eGFRcre was defined as eGFRcre being ≥120% of cystatin C-based eGFR.
Results:
The proportion of heart failure patients with OE was 14.3%. Patients with OE were older, had lower body weight and total skeletal muscle mass than those in patients without OE. Laboratory examinations showed that hemoglobin concentration was lower, and the ratio of blood urea nitrogen-to-creatinine was higher in patients with OE than in patients without OE. In multivariate regression analysis, body weight (<63.0 kg in men and <42.0 kg in women), hemoglobin level (<12.4 g/dL in men and <11.0 g/dL in women) and ratio of blood urea nitrogen-to-creatinine (>26.5) in addition to skeletal muscle mass were independently associated with OE. A score calculated by using cut-off levels of body weight, hemoglobin concentration and ratio of blood urea nitrogen-to-creatinine predicted OE with a sensitivity of 97.1% and a specificity of 98.1%.
Conclusion:
Overestimation of GFR by eGFRcre is predictable by a novel scoring system, which might be useful for the detection of patients who require cystatin C-based eGFR measurement for accurate assessment of renal function. Geriatr Gerontol Int 2020; 20: 752-758.
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