Abstract 15723: Glomerular Filtration Rate Estimated by Cystatin C-Based versus Creatinine-Based Equations for Predicting Mortality in Outpatients With Type 2 Diabetes Mellitus
Background: Recently, new glomerular filtration rate (GFR)-estimating equations based on standard cystatin C for a Japanese population were developed. We prospectively investigated whether GFR estimated by the serum cystatin C-based equations (GFRcys) was superior to GFR estimated by the serum creatinine-based equations (GFRcr) for predicting all-cause mortality in outpatients with type 2 diabetes mellitus.
Methods: A total of 494 consecutive outpatients with type 2 diabetes mellitus and GFRcr ≥15 mL/min/1.73 m2 were examined by the measurement of GFRcys and GFRce, and were followed up 4 years. Among these patients, 9.5% had a history of old myocardial infarction, and 59.3% had a history of hypertension. GFRcys and GFRcr were calculated by the following formulas; GFRcys = [104 х (cystatin C)-1.019 х 0.996age х 0.929 (if female)] - 8, GFRcr = 194 х (creatinine)-1.094 х (age)-0.287 х 0.739 (if female).
Results: GFRcys was positively correlated with GFRcr (r = 0.90, P <0.0001): During a median follow-up period of 1401 days, there were 32 (19%) all-cause deaths including 16 cardiovascular deaths. In stepwise Cox regression analyses including GFRcys and GFRcr (either as continuous variables or as variables categorized into tertiles), age, male sex, medical histories, systolic blood pressure, and B-type natriuretic peptide, high sensitive C-reactive protein and urinary albumin excretion, GFRcys (p = 0.01 and p = 0.01), but not GFRcr, was independently associated with all-cause mortality. The area under the receiver operating characteristic curve for GFRcys between patients who died and who did not was higher than that for GFRcr (0.69 vs. 0.63). Relative risks of all-cause mortalities according to tertiles of GFRcys and GFRcr were shown in Figure.
Conclusion: GFRcys could more accurately predict the mortality than GFRcr in outpatients with type 2 diabetes mellitus.
- © 2013 by American Heart Association, Inc.