Nephrology & Urology

Biography

Biography: Vidhia Umami

Abstract

Staging of chronic kidney disease (CKD) is based on the glomerolus filtration rate (GFR). Every stage has their own treatment. Once the GFR getting lower, there could be many complications happen and it must be treated as soon as possible. The gold standard of GFR count is complicated, need long time, and expensive. Therefore, there are some equations to result estimated GFR using some variabels: age, gender, ras, and serum creatinine, named Modification of Diet on Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-Epi_SCr). Since 2012, There has been a variabel added to the CKD-Epi equations, which is cystatin C. It is still questionable, which equation between MDRD, CKD-Epi using serum creatinine (CKD-EpiSCr), cystatin C (CKD-Epi_CysC), and both of them (CKD-Epi_SCr-CysC) that will have the biggest effectifity, especially for Asian ras to determine the stage of CKD. The literature searching was done in PubMed, Cohcrane, and Science Direct using five keywords and either its abbreviations or accronyms. Using inclusion and exclusions criteria, generated three final articles. Then, critical appraisal was done based on validity, importance, and applicability criteria. The article from Feng J et al, Zhu Y et al, and Zhang M et al with randomized controlled trial (RCT) design showed that the three article was valid, using the gold standard antechnetium-diethylenetriamine pentaacetic acid (Tc-DTPA) imaging. The CKD-EpiCysC and CKD-EpiSCr-CysC equations have the best sensitivity, which are good for screening CKD while the MDRD and CKD-EpiSCr have the best specificity, which are good for diagnosis confirmation of CKD. The best accuracy belongs to CKD-EpiCysC equation, making it great for the real stage of CKD. The best precision belongs to MDRD equation, so it will be great for the evaluation and monitoring of the patient’s disease.