DOI: 10.36347/sjams.2020.v08i10.025

Pages: 2347-2351

Objective: In this study our main goal is to evaluate the comparison of glomerular filtration rate (GFR) estimation by cystatin C with creatinine-based methods in relation to isotope-based method (99m-Tc DTPA plasma clearance) as gold standard in patients with chronic kidney disease. Method: This cross-sectional study was carried out in the outpatient department of nephrology, Sir Salimullah Medical College and Mitford hospital; Bangabandhu Sheikh Mujib Medical University and National institute of nuclear medicine and allied sciences (NINMAS), BSMMU, Dhaka from June 2016 to May 2017.A total of 120 Chronic kidney disease patients attending outpatient departments in above institutions were included in the study. Results: During the study, in all CKD patients the mean value of MDRD (36±14), CG (31±14) and CKD-EPI (31±15) which were significantly different (p<0.001) from the mean value of m-GFR method (40±14). Whereas significant difference was not observed (p=0.571) between the value of e-GFR-Hoek’s (39±16) and m-GFR (40±14).Significant correlation was found between m-GFR with MDRD (r=0.724, p<0.001), CG (r=0.697, p<0.001), CKD-EPI (r=0.721, p<0.001), e-GFR Hoek’s (r=0.748, p<0.001). It was observed that e-GFR Hoek’s (r=0.748, p<0.001) were more correlated with m-GFR than all other methods. cystatin C based method [e-GFR Hoek’s (AUC=0.965, Sensitivity 97 %, Specificity 76 %, p <0.0001)] had a significantly higher diagnostic accuracy than creatinine based methods [MDRD (AUC=0.914, Sensitivity 100 %, Specificity 23%, p <0.0001), CG (AUC=0.907, Sensitivity 99 %, Specificity 30 %, p <0.0001) and CKD-EPI (AUC=0.908, Sensitivity 98 %, Specificity 30 %, p <0.0001)]. Conclusion: From our study we can conclude that, serum cystatin C based estimated GFR showed better correlation with measured GFR in patients with CKD. Its diagnostic accuracy and agreement was found high with measured GFR than creatinine. Thus, cystatin C would be a good alternative marker for estimation of .....