Triple Marker Approach of Peralta et al for Evaluating a Patient with Chronic Kidney Disease

Description

Peralta et al evaluated patients with chronic kidney disease (CKD) using 3 markers (creatinine, cystin C, and the urine albumin-to-creatinine ratio). These can help to identify a patient who may progress to end-stage renal disease or die. The authors are from San Francisco VA Medical Center, University of California at San Francisco, University of Alabama, University of Vermont and Emory University.

Stage 3 to 5 chronic kidney disease was defined as an estimated GFR < 60 mL per min per 1.73 square meter BSA.

Markers:

(1) estimated creatinine clearance in mL per min per 1.73 square meter BSA

(2) cystin C clearance in mL per min per 1.73 square meter BSA

(3) urine albumin-to-creatinine ratio in mg per g on a spot urine

Marker	Normal	Abnormal
creatinine clearance in mL per min per 1.73 sq m	>= 60	< 60
cystin C clearance in mL per min per 1.73 sq m	>= 60	< 60
urine albumin-to-creatinine ratio in mg/g	< 30	>= 30 (albuminuria)

Creatinine Clearance	Cystin C Clearance	Urine Albumin to Creatinine Ratio	Mortality Per 1,000 Patient Years
normal	normal	normal	9.5
normal	normal	abnormal	23
normal	abnormal	normal	41
normal	abnormal	abnormal	64
abnormal	normal	normal	10.2
abnormal	normal	abnormal	44
abnormal	abnormal	normal	44
abnormal	abnormal	abnormal	79

Creatinine Clearance	Cystin C Clearance	Urine Albumin to Creatinine Ratio	End-Stage Renal Disease Per 1,000 Patient Years
normal	normal	normal	0.1
normal	normal	abnormal	1.1
normal	abnormal	normal	0.7
normal	abnormal	abnormal	6.3
abnormal	normal	normal	0.2
abnormal	normal	abnormal	1.4
abnormal	abnormal	normal	2.8
abnormal	abnormal	abnormal	34

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Description

Specialty

ICD-10