Optimising the assessment of renal function and determining the renal elimination of drugs using various methodologies

TL;DRAbstract

The global aim of this PhD thesis is to explore a number of methodologies to optimise the assessment of renal function and investigate the renal elimination of drugs. It is unclear in the literature whether cystatin C (CysC) is a better predictor of renal impairment than serum creatinine (SCr). A systematic review was undertaken to compare the diagnostic accuracy of CysC versus SCr which identified 27 population-groups in 24 studies (total number of people, n=2007) that compared the diagnostic accuracy of CysC with SCr. Metatesti?½ and RevMani?½ were the softwares applied in this meta-analysis study. The diagnostic odds ratios (DORs) (95%CI) of predicting renal dysfunction derived from a Moses-Littenberg linear regression model were 3.99 (3.41-4.57) for CysC and 2.79 (2.12-3.46) for SCr. The diagnostic accuracy for impaired renal function favours CysC, however, CysC does not offer a statistically significant advantage over SCr, the confidence intervals of the DORs overlap. Further stud

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