Package 'nephro'

Title: Utilities for Nephrology
Description: Set of functions to estimate kidney function and other phenotypes of interest in nephrology based on different biomechimal traits.
Authors: Cristian Pattaro, Ryosuke Fujii, Janina Herold
Maintainer: Cristian Pattaro <[email protected]>
License: GPL (>= 3)
Version: 1.4
Built: 2024-11-16 04:18:58 UTC
Source: https://github.com/cran/nephro

Help Index


Biostatistics utilities for nephrology

Description

This package contains a set of tools for the estimation of kidney function. Kidney function is assessed by means of the Glomerular Filtration Rate (GFR), which can be estimated using different biomarkers. The most commonly used ones are serum or plasma creatinine and cystatin C.

Included in the package are the following GFR estimating functions: the Modification of Diet in Renal Disease (MDRD) study equations based on four (MDRD4) or six (MDRD6) parameters (Levey 1999; Levey 2006); the CKD-Epi equations for serum creatinine with the race coefficient (CKDEpi.creat) and without the race coefficient (CKDEpi_RF.creat); the CKD-Epi equation for cystatin C (CKDEpi.cys); the CKD-Epi equation for the combination of creatinine and cystatin C with (CKDEpi.creat.cys) and without (CKDEpi_RF.creat.cys) the race coefficient (Inker 2012; Inker 2021); the three equations proposed by Stevens 2008 based on cystatin C only (Stevens.cys1), age- and sex-weighted cystatin C (Stevens.cys2), and a combination of cystatin C and creatinine (Stevens.creat.cys); the classic Cockroft and Gault 1976 equation for creatinine clearance estimation (CG); the equation by Virga (2007) (Virga); the race-free equations developed by the European Kidney Function Consortium (EKFC) including sex and age based on serum creatinine (EKFC.creat) (Pottel 2021) and based on serum cystatin C with (EKFC.cys) and without (EKFC_SF.cys) the sex coefficient (Pottel 2023); the full age spectrum (FAS) equations using serum creatinine (FAS.creat) (Pottel 2016), cystatin C (FAS.cys), and their combination (FAS.creat.cys) (Pottel 2017); the Schwartz bedside formula (Schwartz.Bedside) (Schwartz 2009).

A comparative description of several functions included in the initial version of the package can be found in Pattaro (2013). Extensive literature does exist that compares the methods described.

Details

Package: nephroext
Type: Package
Version: 1.4
Date: 2023-10-10
License: GPLv3

Author(s)

Cristian Pattaro <[email protected]>, Ryosuke Fujii <[email protected]>, Janina Herold <[email protected]>

Acknowledgements: Max Plischke, Joao Sabino, Xiao Jiang for bug reporting; Alexander Tolios, Thomas Winkler for input on the software package; Andrew Srisuwananukorn for contributing scripts; the 'nephro' user community for continuous feedback.

References

Citing this package:
- Pattaro C, Riegler P, Stifter G, Modenese M, Minelli C, Pramstaller PP. Estimating the glomerular filtration rate in the general population using different equations: effects on classification and association. Nephron Clin Pract 2013; 123(1-2):102-11.

Formulas:
- Cockroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16: 31-41.
- Inker LA, et al. Estimating glomerular filtration rate from serum creatinine and cystatin C. N Engl J Med 2012; 367: 20-9.
- Inker LA, et al. New Creatinine- and Cystatin C-based Equations to Estimate GFR without Race. N Engl J Med 2021; 385: 1737-1749.
- Levey AS, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999; 130(6): 461-70.
- Levey AS, et al. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006; 145: 247-54.
- Stevens LA, et al. Estimating GFR using serum cystatin C alone and in combination with serum creatinine: a pooled analysis of 3,418 individuals with CKD. Am J Kidney Dis 2008; 51: 395-406.
- Virga G, et al. A new equation for estimating renal function using age, body weight and serum creatinine. Nephron Clin Pract 2007; 105: c43-53.
- Pottel H, et al. Development and Validation of a Modified Full Age Spectrum Creatinine-Based Equation to Estimate Glomerular Filtration Rate: A Cross-sectional Analysis of Pooled Data. Ann Intern Med 2021; 174: 183-191.
- Pottel H, et al. Cystatin C-Based Equation to Estimate GFR without the Inclusion of Race and Sex. N Engl J Med 2023; 388: 333-343.
- Pottel H, et al. An estimated glomerular filtration rate equation for the full age spectrum. Nephrol Dial Transplant 2016; 31:798-806.
- Pottel H, et al. Estimating glomerular filtration rate for the full age spectrum from serum creatinine and cystatin C Nephrol Dial Transplant 2017; 32: 497-507.
- Schwartz GJ, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol 2009; 20:629-637.

On IDMS calibration:
- Levey AS, et al. Expressing the Modification of Diet in Renal Disease Study equation for estimating glomerular filtration rate with standardized serum creatinine values. Clin Chem 2007; 53:766-72.
- Matsushita K, et al. Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate. J Am Med Assoc 2012; 307:1941-51.
- Skali H, et al. Prognostic assessment of estimated glomerular filtration rate by the new Chronic Kidney Disease Epidemiology Collaboration equation in comparison with the Modification of Diet in Renal Disease Study equation. Am Heart J 2011; 162:548-54.

Examples

# Comparison between different equations

creat <- c(0.8, 0.9, 1.0, 1.1, 1.2, 1.3)
cyst  <- c(1.1, 0.95, 1.1, 1.0, 1.3, 1.2)
sex <- c(1, 1, 1, 0, 0, 0)
age <- c(60, 65, 43, 82, 71, 55)
ethn <- round(runif(6))
wt <- c(70, 80, 60, 55, 87, 71)

eGFR <- data.frame(creat, cyst)
eGFR$MDRD4 <- MDRD4(creat, sex, age, ethn, 'IDMS')
eGFR$CKDEpi.creat <- CKDEpi.creat(creat, sex, age, ethn) 
eGFR$CKDEpi_RF.creat <- CKDEpi_RF.creat(creat, sex, age)
eGFR$CKDEpi.cys <- CKDEpi.cys(cyst, sex, age)
eGFR$CKDEpi.creat.cys <- CKDEpi.creat.cys(creat, cyst, sex, age, ethn)
eGFR$CKDEpi_RF.creat.cys <- CKDEpi_RF.creat.cys(creat, cyst, sex, age)
eGFR$Stevens.cys1 <- Stevens.cys1(cyst)
eGFR$Stevens.cys2 <- Stevens.cys2(cyst, sex, age, ethn)
eGFR$Stevens.creat.cys <- Stevens.creat.cys(creat, cyst, sex, age, ethn)
eGFR$cg <- CG(creat, sex, age, wt)
eGFR$virga <- Virga(creat, sex, age, wt)

pairs(eGFR[,3:13])

# For use with non-IDMS calibrated creatinine 
# several authors (see references) suggested
# a 5% creatinine adjustment

creat <- c(0.8, 0.9, 1.0, 1.1, 1.2, 1.3)
sex <- c(1, 1, 1, 0, 0, 0)
age <- c(60, 65, 43, 82, 71, 55)
ethn <- round(runif(6))
gfr <- CKDEpi.creat(0.95*creat, sex, age, ethn)

Cockroft and Gault equation

Description

Creatinine clearance is estimated with the Cockroft and Gault formula.

Usage

CG(creatinine, sex, age, wt)

Arguments

creatinine

Numeric vector with serum or plasma creatinine values in mg/dl

sex

Numeric vector with 0 for females and 1 for males

age

Numeric vector with age in years

wt

Numeric vector with weight in kg

Value

A numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Cristian Pattaro

References

Cockroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16: 31-41.

See Also

CKDEpi.creat, MDRD4, Virga


Race-free CKD-EPI equation for serum creatinine

Description

GFR is estimated with the CKD-EPI Study equation based on serum creatinine without the ethnicity coefficient.

Usage

CKDEpi_RF.creat(creatinine, sex, age)

Arguments

creatinine

Numeric vector with serum or plasma creatinine values in mg/dl

sex

Numeric vector with 0 for females and 1 for males

age

Numeric vector with age in years

Value

A numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Ryosuke Fujii

References

Inker LA, et al. New creatinine- and cystatin C-based equations to estimate GFR without race. N Engl J Med 2021; 385: 1737-1749.

See Also

CKDEpi.creat, CKDEpi.creat.cys, CKDEpi.cys, CKDEpi_RF.creat.cys


Race-free CKD-EPI equation for serum creatinine and cystatin C

Description

CKD-EPI equation to estimate GFR based on a combination of creatinine and cystatin C without the ethnicity coefficient

Usage

CKDEpi_RF.creat.cys(creatinine, cystatin, sex, age)

Arguments

creatinine

Numeric vector with serum or plasma creatinine values in mg/dl

cystatin

Numeric vector with serum or plasma cystatin C values in mg/l

sex

Numeric vector with 0 for females and 1 for males

age

Numeric vector with age in years

Value

A numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Ryosuke Fujii

References

Inker LA, et al. New creatinine- and cystatin C-based equations to estimate GFR without race. N Engl J Med 2021; 385: 1737-1749.

See Also

CKDEpi.creat, CKDEpi.creat.cys, CKDEpi.cys, CKDEpi_RF.creat


CKD-EPI equation for serum creatinine

Description

GFR is estimated with the CKD-EPI Study equation based on IDMS serum or plasma creatinine.

Usage

CKDEpi.creat(creatinine, sex, age, ethnicity)

Arguments

creatinine

Numeric vector with serum or plasma creatinine values in mg/dl

sex

Numeric vector with 0 for females and 1 for males

age

Numeric vector with age in years

ethnicity

Numeric vector with 0 for non-Black and 1 for Black individuals

Value

A numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Cristian Pattaro

References

Inker LA, et al. Estimating glomerular filtration rate from serum creatinine and cystatin C. N Engl J Med 2012; 367: 20-29.

See Also

CKDEpi.creat.cys, CKDEpi.cys, CKDEpi_RF.creat


CKD-EPI equation for creatinine and cystatin C

Description

CKD-EPI equation to estimate GFR based on a combination of creatinine and cystatin C

Usage

CKDEpi.creat.cys(creatinine, cystatin, sex, age, ethnicity)

Arguments

creatinine

Numeric vector with serum or plasma creatinine values in mg/dl

cystatin

Numeric vector with serum or plasma cystatin C values in mg/dl

sex

Numeric vector with 0 for females and 1 for males

age

Numeric vector with age in years

ethnicity

Numeric vector with 0 for non-Black and 1 for Black individuals

Value

A numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Cristian Pattaro

References

Inker LA, et al. Estimating glomerular filtration rate from serum creatinine and cystatin C. N Engl J Med 2012; 367: 20-29.

See Also

CKDEpi.creat, CKDEpi.cys, CKDEpi_RF.creat.cys


CKD-EPI equation for cystatin C

Description

GFR is estimated with the CKD-EPI equation for cystatin C proposed by Inker et al., N Engl J Med 2012

Usage

CKDEpi.cys(cystatin, sex, age)

Arguments

cystatin

Numeric vector with serum or plasma cystatin C values in mg/l

sex

Numeric vector with 0 for females and 1 for males

age

Numeric vector with age in years

Value

The function returns a numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Cristian Pattaro

References

Inker LA, et al. Estimating glomerular filtration rate from serum creatinine and cystatin C. N Engl J Med 2012; 367: 20-29.

See Also

CKDEpi.creat, CKDEpi.creat.cys


Sex-free EKFC equation for cystatin C

Description

EKFC equation for cystatin C without the sex coefficient as proposed by Pottel et al., N Engl J Med 2023

Usage

EKFC_SF.cys(cystatin, age)

Arguments

cystatin

Numeric vector with serum or plasma cystatin C values in mg/l

age

Numeric vector with age in years

Value

The function returns a numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Janina Herold

References

Pottel, H, et al. Cystatin C-Based Equation to Estimate GFR without the Inclusion of Race and Sex. N Engl J Med 2023; 388: 333-343.

See Also

EKFC.cys


EKFC equation for serum creatinine

Description

EKFC equation for serum creatinine modified from FAS equation

Usage

EKFC.creat(creatinine, sex, age)

Arguments

creatinine

Numeric vector with serum or plasma creatinine values in mg/dl

sex

Numeric vector with 0 for females and 1 for males

age

Numeric vector with age in years

Value

The function returns a numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Janina Herold

References

Pottel, H, et al. Development and Validation of a Modified Full Age Spectrum Creatinine-Based Equation to Estimate Glomerular Filtration Rate : A Cross-sectional Analysis of Pooled Data. N Engl J Med 2021; 174: 183-191.

See Also

EKFC.cys, CKDEpi.creat


EKFC equation for cystatin C

Description

EKFC equation for cystatin C that includes the sex coefficient, as proposed by Pottel et al., N Engl J Med 2023

Usage

EKFC.cys(cystatin, sex, age)

Arguments

cystatin

Numeric vector with serum or plasma cystatin C values in mg/l

sex

Numeric vector with 0 for females and 1 for males

age

Numeric vector with age in years

Value

The function returns a numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Janina Herold

References

Pottel, H, et al. Cystatin C-Based Equation to Estimate GFR without the Inclusion of Race and Sex. N Engl J Med 2023; 388: 333-343.

See Also

EKFC_SF.cys


FAS equation for serum creatinine

Description

Full age spectrum (FAS) equation to estimate GFR based on serum creatinine

Usage

FAS.creat(creatinine, sex, age)

Arguments

creatinine

Numeric vector with serum or plasma creatinine values in mg/dl

sex

Numeric vector with 0 for females and 1 for males

age

Numeric vector with age in years

Value

A numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Janina Herold

References

Pottel, H., et al. An estimated glomerular filtration rate equation for the full age spectrum. Nephrol Dial Transplant. 2016; 5: 798-806.

See Also

FAS.creat.cys, FAS.cys


FAS equation for creatinine and cystatin C

Description

Full age spectrum (FAS) GFR estimation based on serum creatinine and cystatin C

Usage

FAS.creat.cys(creatinine, cystatin, sex,age)

Arguments

creatinine

Numeric vector with serum or plasma creatinine values in mg/dl

cystatin

Numeric vector with serum or plasma cystatin C values in mg/l

sex

Numeric vector with 0 for females and 1 for males

age

Numeric vector with age in years

Value

The function returns a numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Janina Herold

References

Pottel, H., et al. An estimated glomerular filtration rate equation for the full age spectrum from serum creatinine and cystatin C. Nephrol Dial Transplant. 2017; 32: 497-507.

See Also

FAS.cys


FAS equation for cystatin C

Description

Full age spectrum (FAS) GFR estimation based on cystatin C

Usage

FAS.cys(cystatin, sex, age)

Arguments

cystatin

Numeric vector with serum or plasma cystatin values in mg/l

sex

Numeric vector with 0 for females and 1 for males

age

Numeric vector with age in years

Value

A numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Janina Herold

References

Pottel, H., et al. An estimated glomerular filtration rate equation for the full age spectrum from serum creatinine and cystatin C. Nephrol Dial Transplant. 2017; 32: 497-507.

See Also

FAS.creat, FAS.creat.cys


Four-parameter MDRD study equation

Description

GFR is estimated with the 4-parameter Modification of Diet in Renal Disease (MDRD) study equation.

Usage

MDRD4(creatinine, sex, age, ethnicity, method = "IDMS")

Arguments

creatinine

Numeric vector with serum or plasma creatinine values in mg/dl

sex

Numeric vector with 0 for females and 1 for males

age

Numeric vector with age in years

ethnicity

Numeric vector with 0 for non-Black and 1 for Black individuals

method

Defaults is 'IDMS' for IDMS-traceable creatinine; write 'other' if not IDMS

Value

A numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Cristian Pattaro

References

Levey AS, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999; 130(6): 461-70.
Levey AS, et al. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006; 145: 247-254.

See Also

CKDEpi.creat, MDRD6, CG


Six-parameter MDRD study equation

Description

GFR is estimated with the 6-parameter Modification of Diet in Renal Disease (MDRD) study equation.

Usage

MDRD6(creatinine, sex, age, albumin, BUN, ethnicity, method = 'IDMS')

Arguments

creatinine

Numeric vector with serum or plasma creatinine values in mg/dl

sex

Numeric vector with 0 for females and 1 for males

age

Numeric vector with age in years

albumin

Numeric vector with serum or plasma albumin in g/dl

BUN

Numeric vector with blood urea nitrogen levels in mg/dl

ethnicity

Numeric vector with 0 for non-Black and 1 for Black individuals

method

Defaults is 'IDMS' for IDMS-traceable creatinine; write 'other' if not IDMS

Value

A numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Cristian Pattaro

References

Levey AS, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999; 130(6): 461-70.
Levey AS, et al. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006; 145: 247-254.

See Also

MDRD4


Bedside IDMS-traceable Schwartz GFR Calculator for Children

Description

GFR is estimated with the Bedside Schwartz equation for Children based on IDMS serum or plasma creatinine.
This equation is valid in the 1-17 years age range.

Usage

Schwartz.Bedside(creatinine, ht, age)

Arguments

creatinine

Numeric vector with serum or plasma creatinine values in mg/dl

ht

Numeric vector with height in cm

age

Numeric vector with age in years

Value

A numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Andrew Srisuwananukorn

References

Schwartz GJ, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol 2009; 20: 629-637.


Stevens' formula for a combination of serum creatinine and cystatin C

Description

GFR estimation using the 3rd formula proposed by Stevens et al. (Am J Kidney Dis 2008), which combines creatinine and cystatin C

Usage

Stevens.creat.cys(creatinine, cystatin, sex, age, ethnicity)

Arguments

creatinine

Numeric vector with serum or plasma creatinine values in mg/dl

cystatin

Numeric vector with serum or plasma cystatin C values in mg/l

sex

Numeric vector with 0 for females and 1 for males

age

Numeric vector with age in years

ethnicity

Numeric vector with 0 for non-Black and 1 for Black individuals

Value

The function returns a numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Cristian Pattaro

References

Stevens LA, et al. Estimating GFR using serum cystatin C alone and in combination with serum creatinine: a pooled analysis of 3,418 individuals with CKD. Am J Kidney Dis 2008; 51: 395-406.

See Also

CKDEpi.creat.cys


GFR estimation using serum cystatin C

Description

GFR is estimated with the 1st formula proposed by Stevens et al. (Am J Kidney Dis 2008), i.e.: as a simple transformation of cystatin C, without using any other information

Usage

Stevens.cys1(cystatin)

Arguments

cystatin

Numeric vector with serum or plasma cystatin C values in mg/l

Value

A numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Cristian Pattaro

References

Stevens LA, et al. Estimating GFR using serum cystatin C alone and in combination with serum creatinine: a pooled analysis of 3,418 individuals with CKD. Am J Kidney Dis 2008; 51: 395-406.

See Also

Stevens.cys2, Stevens.creat.cys, CKDEpi.cys


Stevens' formula for serum cystatin C, age, and sex

Description

GFR is estimated with the 2nd formula proposed by Stevens et al. (Am J Kidney Dis 2008), where cystatin C is weighted by sex and age

Usage

Stevens.cys2(cystatin, sex, age, ethnicity)

Arguments

cystatin

Numeric vector with serum or plasma cystatin C values in mg/l

sex

Numeric vector with 0 for females and 1 for males

age

Numeric vector with age in years

ethnicity

Numeric vector with 0 for non-Black and 1 for Black individuals

Value

A numeric vector with eGFR values in ml/min/1.73 m2m^2.

Author(s)

Cristian Pattaro

References

Stevens LA, et al. Estimating GFR using serum cystatin C alone and in combination with serum creatinine: a pooled analysis of 3,418 individuals with CKD. Am J Kidney Dis 2008; 51: 395-406.

See Also

Stevens.cys1, Stevens.creat.cys, CKDEpi.cys


Virga's formula

Description

Virga's formula is based on serum creatinine, sex, age, and body weight.

Usage

Virga(creatinine, sex, age, wt)

Arguments

creatinine

Numeric vector with serum or plasma creatinine values in mg/dl

sex

Numeric 0/1 vector: 0 for females, 1 for males

age

Numeric vector with age in years

wt

Numeric vector with weight in kg

Value

A numeric vector with eGFR values in ml/min/1.73 m^2

Author(s)

Cristian Pattaro

References

Virga G, et al. A new equation for estimating renal function using age, body weight and serum creatinine. Nephron Clin Pract 2007; 105: c43-53.

See Also

CG, MDRD4