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Licensed Unlicensed Requires Authentication Published by De Gruyter November 14, 2011

Age- and sex-specific reference limits for creatinine, cystatin C and the estimated glomerular filtration rate

  • Anke Hannemann EMAIL logo , Nele Friedrich , Kathleen Dittmann , Christin Spielhagen , Henri Wallaschofski , Henry Völzke , Rainer Rettig , Karlhans Endlich , Uwe Lendeckel , Sylvia Stracke and Matthias Nauck

Abstract

Background: Early detection of patients with chronic kidney disease is of great importance. This study developed reference limits for serum creatinine and serum cystatin C concentrations and for the estimated glomerular filtration rate (eGFR) in healthy subjects from the general population aged 25–65 years.

Methods: This study defined a reference population including 985 subjects from the first follow-up of the Study of Health in Pomerania. Serum creatinine was measured with a modified kinetic Jaffé method. Serum cystatin C was measured with a nephelometric assay. The eGFR was calculated from serum creatinine according to the Cockcroft-Gault (eGFRCG) and the Modification of Diet in Renal Disease (eGFRMDRD) equation, respectively, as well as from serum cystatin C according to the formula by Larsson (eGFRLarsson). Non-parametric quantile regression was used to estimate the reference limits. For serum creatinine and serum cystatin C the 95th percentile and for eGFRCG, eGFRMDRD and eGFRLarsson the 5th percentile were selected as reference limits. All data was weighted to reflect the age- and sex-structure of the German population in 2008.

Results: The reference limits for serum creatinine (men: 1.11–1.23 mg/dL; women: 0.93–1.00 mg/dL) and serum cystatin C levels (men: 0.92–1.04 mg/L; women: 0.84–1.02 mg/L) increased with advancing age. The reference limits for eGFR decreased with increasing age (eGFRCG men: 106.0–64.7 mL/min, women 84.4–57.9 mL/min; eGFRMDRD men: 82.5–62.2 mL/min/1.73 m2, women 75.0–58.2 mL/min/1.73 m2; eGFRLarsson men: 85.5–72.9 mL/min, women 94.5–75.7 mL/min).

Conclusions: This study presents age- and sex-specific reference limits for five measures of renal function based on quantile regression models.


Corresponding author: Anke Hannemann, Institute of Clinical Chemistry and Laboratory Medicine, Ernst-Moritz-Arndt University Greifswald, Ferdinand-Sauerbruch Straße, 17475 Greifswald, Germany Phone: +49 3843 86 19657, Fax: +49 3834 86 6684

Received: 2011-8-22
Accepted: 2011-10-21
Published Online: 2011-11-14
Published in Print: 2012-05-01

©2012 by Walter de Gruyter Berlin Boston

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