Estimating glomerular filtration rate for the full age spectrum from serum creatinine and cystatin C

Hans Pottel, Pierre Delanaye, Elke Schaeffner, Laurence Dubourg, Bjørn Odvar Eriksen, Toralf Melsom, Edmund J. Lamb, Andrew D. Rule, Stephen T. Turner, Richard J. Glassock, Vandréa De Souza, Luciano Selistre, Karolien Goffin, Steven Pauwels, Christophe Mariat, Martin Flamant, Natalie Ebert

Research output: Contribution to journalArticlepeer-review

100 Scopus citations


Background. We recently published and validated the new serum creatinine (Scr)-based full-age-spectrum equation (FAScrea) for estimating the glomerular filtration rate (GFR) for healthy and kidney-diseased subjects of all ages. The equation was based on the concept of normalized Scr and shows equivalent to superior prediction performance to the currently recommended equations for children, adolescents, adults and older adults. Methods. Based on an evaluation of the serum cystatin C (ScysC) distribution, we defined normalization constants for ScysC (QcysC = 0.82 mg/L for ages <70 years and QcysC = 0.95 mg/L for ages ≥70 years). By replacing Scr/Qcrea in the FAScrea equation with ScysC/QcysC, or with the average of both normalized biomarkers, we obtained new ScysC-based (FAScysC) and combined Scr-/ScysC-based FAS equations (FAScombi). To validate the new FAScysC and FAScombi we collected data on measured GFR, Scr, ScysC, age, gender, height and weight from 11 different cohorts including n = 6132 unique white subjects (368 children, aged ≤18 years, 4295 adults and 1469 older adults, aged ≥70 years). Results. In children and adolescents, the new FAScysC equation showed significantly better performance [percentage of patients within 30% of mGFR (P30) = 86.1%] than the Caucasian Asian Paediatric Adult Cohort equation (P30 = 76.6%; P < 0.0001), or the ScysC-based Schwartz equation (P30 = 68.8%; P < 0.0001) and the FAScombi equation outperformed all equations with P30 = 92.1% (P < 0.0001). In adults, the FAScysC equation (P30 = 82.6%) performed equally as well as the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPIcysC) (P30 = 80.4%) and the FAScombi equation (P30 = 89.9%) was also equal to the combined CKD-EPI equation (P30 = 88.2%). In older adults, FAScysC was superior (P30 = 88.2%) to CKD-EPIcysC (P30 = 84.4%; P < 0.0001) and the FAScombi equation (P30 = 91.2%) showed significantly higher performance than the combined CKD-EPI equation (P30 = 85.6%) (P < 0.0001). Conclusion. The FAS equation is not only applicable to all ages, but also for all recommended renal biomarkers and their combinations.

Original languageEnglish (US)
Pages (from-to)497-507
Number of pages11
JournalNephrology Dialysis Transplantation
Issue number3
StatePublished - Mar 1 2017


  • all ages
  • all renal biomarkers
  • combined FAS equation
  • cystatin C
  • serum creatinine

ASJC Scopus subject areas

  • Nephrology
  • Transplantation


Dive into the research topics of 'Estimating glomerular filtration rate for the full age spectrum from serum creatinine and cystatin C'. Together they form a unique fingerprint.

Cite this