For GFR estimates based on cystatin C (estimated GFR (eGFR cys)), percentage bias varied between -1 and 37, and percentage precision between 21 and 37. The bias, precision, and accuracy of the investigated equations in Table 2 are shown in Table 3. Hence, the better prediction of cardiovascular disease by cystatin C than creatinine measurements, found by others, may be due to factors other than GFR. Thus, estimates of GFR based on cystatin C were not superior to those based on creatinine in the general population. The best equation, based on both cystatin C and creatinine, had a bias of 7.6 ml/min per 1.73 m 2, precision of 15 ml/min per 1.73 m 2, and accuracy of 92%. The cystatin C-based equation with the highest accuracy (94%) had a bias of 3.5 and precision of 18 ml/min per 1.73 m 2, whereas the most accurate (95%) creatinine-based equation had a bias of 2.9 and precision of 15 ml/min per 1.73 m 2. Bias, precision (median and interquartile range of estimated minus measured GFR (mGFR)), and accuracy (percentage of estimates within 30% of mGFR) of published cystatin C and creatinine-based GFR equations were compared in a total of 1621 patients. To test this, we measured GFR by iohexol clearance in a representative sample of middle-aged (50–62 years) individuals in the general population, excluding those with coronary heart or kidney disease, stroke or diabetes mellitus. Because estimates based on cystatin C predict cardiovascular disease better than creatinine, these estimates have been hypothesized to be superior to those based on creatinine, when the GFR is near the normal range. ![]() Accurate measurement of glomerular filtration rate (GFR) is complicated and costly therefore, GFR is commonly estimated by assessing creatinine or cystatin C concentrations.
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