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A Meta-Analysis on the Performance of Cystatin C- versus Creatinine-based eGFR Equations in Predicting Vancomycin Clearance

Journal of Korean Medical Science 2020년 35권 37호 p.306 ~ 306
Tahir Nor Asyikin Mohd, Saffian Shamin Mohd, Islahudin Farida Hanim, Gafor Abdul, Makmor-Bakry Mohd,
소속 상세정보
 ( Tahir Nor Asyikin Mohd ) - Universiti Kebangsaan Malaysia Faculty of Pharmacy
 ( Saffian Shamin Mohd ) - Universiti Kebangsaan Malaysia Faculty of Pharmacy
 ( Islahudin Farida Hanim ) - Universiti Kebangsaan Malaysia Faculty of Pharmacy
 ( Gafor Abdul ) - Universiti Kebangsaan Malaysia Medical Centre Department of Medicine
 ( Makmor-Bakry Mohd ) - Universiti Kebangsaan Malaysia Faculty of Pharmacy

Abstract


Background: The objective of this study was to compare the performance of cystatin C- and creatinine-based estimated glomerular filtration rate (eGFR) equations in predicting the clearance of vancomycin.

Methods: MEDLINE and Embase databases were searched from inception up to September 2019 to identify all studies that compared the predictive performance of cystatin C- and/or creatinine-based eGFR in predicting the clearance of vancomycin. The prediction errors (PEs) (the value of eGFR equations minus vancomycin clearance) were quantified for each equation and were pooled using a random-effects model. The root mean squared errors were also quantified to provide a metric for imprecision.

Results: This meta-analysis included evaluations of seven different cystatin C- and creatinine-based eGFR equations in total from 26 studies and 1,234 patients. The mean PE (MPE) for cystatin C-based eGFR was 4.378 mL min?1 (95% confidence interval [CI], ?29.425, 38.181), while the creatinine-based eGFR provided an MPE of 27.617 mL min?1 (95% CI, 8.675, 46.560) in predicting clearance of vancomycin. This indicates the presence of unbiased results in vancomycin clearance prediction by the cystatin C-based eGFR equations. Meanwhile, creatinine-based eGFR equations demonstrated a statistically significant positive bias in vancomycin clearance prediction.

Conclusion: Cystatin C-based eGFR equations are better than creatinine-based eGFR equations in predicting the clearance of vancomycin. This suggests that utilising cystatin C-based eGFR equations could result in better accuracy and precision to predict vancomycin pharmacokinetic parameters.

키워드

Cystatin C; Creatinine; Vancomycin; Clearance; eGFR

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