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

Authors
  • Mohd Tahir, Nor Asyikin1
  • Mohd Saffian, Shamin1
  • Islahudin, Farida Hanim1
  • Abdul Gafor, Abdul Halim2
  • Makmor-Bakry, Mohd3
  • 1 Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. , (Malaysia)
  • 2 Nephrology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Malaysia. , (Malaysia)
  • 3 Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. [email protected] , (Malaysia)
Type
Published Article
Journal
Journal of Korean medical science
Publication Date
Sep 21, 2020
Volume
35
Issue
37
Identifiers
DOI: 10.3346/jkms.2020.35.e306
PMID: 32959542
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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. 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. 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. 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. © 2020 The Korean Academy of Medical Sciences.

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