{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:30:18Z","timestamp":1791358218043,"version":"4.3.1"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","license":[{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl."],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:p>Accurate estimation of kidney function in cirrhosis is crucial for prognosis and decisions regarding dual\u2010organ transplantation. We performed a systematic review\/meta\u2010analysis to assess the performance of creatinine\u2010based and cystatin C (CysC)\u2013based eGFR equations compared with measured GFR (mGFR) in patients with cirrhosis. A total of 25 studies (n = 4565, 52.0 years, 37.0% women) comprising 18 equations met the inclusion criteria. In all GFR equations, the creatinine\u2010based equations overestimated GFR (standardized mean difference, SMD, 0.51; 95% confidence interval [CI], 0.31\u20100.71) and CysC\u2010based equations underestimated GFR (SMD, \u22120.3; 95% CI, \u22120.60 to \u22120.02). Equations based on both creatinine and CysC were the least biased (SMD, \u22120.14; 95% CI, \u22120.46 to 0.18). Chronic kidney disease\u2013Epi\u2013serum creatinine\u2013CysC (CESC) was the least biased but had low precision and underestimated GFR by \u22123.6 mL\/minute\/1.73 m<jats:sup>2<\/jats:sup> (95% CI, \u221217.4 to 10.3). All equations significantly overestimated GFR (+21.7 mL\/minute\/1.73 m<jats:sup>2<\/jats:sup>; 95% CI, 17.7\u201025.7) at GFR &lt;60 mL\/minute\/1.73 m<jats:sup>2<\/jats:sup>; of these, chronic kidney disease\u2013Epi\u2013CysC (10.3 mL\/minute\/1.73 m<jats:sup>2<\/jats:sup>; 95% CI, 2.1\u201018.4) and GFR Assessment in Liver Disease (12.6 mL\/minute\/1.73 m<jats:sup>2<\/jats:sup>; 95% CI, 7.2\u201018.0) were the least biased followed by Royal Free Hospital (15 mL\/minute\/1.73 m<jats:sup>2<\/jats:sup>; 95% CI, 5.5\u201024.6) and Modification of Diet in Renal Disease 6 (15.7 mL\/minute\/1.73 m<jats:sup>2<\/jats:sup>; 95% CI, 10.6\u201020.8); however, there was an overlap in the precision of estimates, and the studies were limited. In ascites, overestimation of GFR was common (+8.3 mL\/minute\/1.73 m<jats:sup>2<\/jats:sup>; 95% CI, \u22123.1 to 19.7). However, overestimation of GFR by 10 to 20 mL\/minute\/1.73m<jats:sup>2<\/jats:sup> is common in patients with cirrhosis with most equations in ascites and\/or kidney dysfunction. A tailored approach is required especially for decisions regarding dual\u2010organ transplantation.<\/jats:p>","DOI":"10.1002\/lt.26216","type":"journal-article","created":{"date-parts":[[2021,6,18]],"date-time":"2021-06-18T11:00:23Z","timestamp":1624014023000},"page":"1538-1552","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":55,"title":["Estimating Glomerular Filtration Rate in Cirrhosis Using Creatinine\u2010Based and Cystatin C\u2013Based Equations: Systematic Review and Meta\u2010Analysis"],"prefix":"10.1097","volume":"27","author":[{"given":"Prianka","family":"Singapura","sequence":"first","affiliation":[{"name":"Baylor University Medical Center,Baylor Scott and White,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung\u2010Wei","family":"Ma","sequence":"additional","affiliation":[{"name":"Baylor University Medical Center,Baylor Scott and White,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveed","family":"Sarmast","sequence":"additional","affiliation":[{"name":"Baylor University Medical Center,Baylor Scott and White,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stevan A.","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Baylor University Medical Center,Baylor Scott and White,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Durand","sequence":"additional","affiliation":[{"name":"Hepatology & Liver Intensive Care,Hospital Beaujon, Clichy, University of Paris,Paris,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakhi","family":"Maiwall","sequence":"additional","affiliation":[{"name":"Institute of Liver & Biliary Sciences,New Delhi,India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitra K.","family":"Nadim","sequence":"additional","affiliation":[{"name":"Division of Nephrology,University of Southern California,Los Angeles,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Fullinwider","sequence":"additional","affiliation":[{"name":"Baylor University Medical Center,Baylor Scott and White,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Saracino","sequence":"additional","affiliation":[{"name":"Baylor University Medical Center,Baylor Scott and White,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Francoz","sequence":"additional","affiliation":[{"name":"Hepatology & Liver Intensive Care,Hospital Beaujon, Clichy, University of Paris,Paris,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Sartin","sequence":"additional","affiliation":[{"name":"Baylor University Medical Center,Baylor Scott and White,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James F.","family":"Trotter","sequence":"additional","affiliation":[{"name":"Baylor University Medical Center,Baylor Scott and White,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9174-5670","authenticated-orcid":false,"given":"Sumeet K.","family":"Asrani","sequence":"additional","affiliation":[{"name":"Baylor University Medical Center,Baylor Scott and White,Dallas,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,8,1]]},"reference":[{"key":"lt26216-bib-0001-20250824","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/j.jhep.2011.10.016","article-title":"Renal failure and cirrhosis: a systematic review of mortality and prognosis","volume":"56","year":"2012","journal-title":"J 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