Error Estimates for Calculated Glomerular Filtration Rates

Glomerular filtration rate (GFR) is a measure of kidney function. It is usually estimated from serum concentrations of cystatin C or creatinine although there has been considerable debate in the literature about (i) the best equation to use and (ii) the variability in the correlation between the concentrations of creatinine and cystatin C. The equations for GFR can be written in a general form and from these I calculate the error of the GFR estimates associated with analyte measurement error. These show that the error of the GFR estimates is such that it is not possible to distinguish between the equations over much of the concentration range of either analyte. The general forms of the equations are also used to derive an expression for the concentration of cystatin C as a function of the concentration of creatinine. This equation shows that these analyte concentrations are not linearly related. Clinical reports of cystatin C and creatinine concentration are consistent with the expression derived. Keywords—creatinine, cystatin C, error analysis, glomerular filtration rate, measurement error.