Serum cystatin C, serum creatinine and the MDRD as predictors for renal function defined by the inulin clearance after orthotopic liver transplantation*

2011 ◽  
Vol 43 (6) ◽  
pp. 333-337
Author(s):  
D. Wagner ◽  
D. Kniepeiss ◽  
P. Stiegler ◽  
M. Sereinigg ◽  
S. Zitta ◽  
...  
Author(s):  
George T John ◽  
Jude Joseph Fleming ◽  
Girish S Talaulikar ◽  
R Selvakumar ◽  
Paaulose P Thomas ◽  
...  

Background: The usefulness of serum cystatin C and serum β2-microglobulin (B2M) as markers of glomerular filtration rate (GFR) were compared in kidney donors before and after nephrectomy. Methods: Blood samples were taken from 28 donors (15 women and 13 men) for serum creatinine, urea, cystatin C and B2M estimation a median of 7 days before and 10 days after nephrectomy. Results: Estimated GFR decreased from a median of 86.2 mL/min/1.73 m2 to 60.3 mL/min/1.73 m2, a median decrease of 28.6%. Serum creatinine increased by 40% and urea by 30.4%; serum cystatin C increased by 31.2% and serum B2M increased by 65.6%. Using published data on biological variation, critical values were calculated. An increase in serum creatinine above 18 µmol/L detected the decline in renal function in 26/28 (92.9%) subjects. Increases in serum B2M greater than a critical value of 0.94 mg/L detected 24/28 (85.7%) of these subjects, but the critical value of 0.59 mg/L for cystatin C detected only 8/28 (28.6%). Conclusion: Using critical values, serial measurement of serum creatinine was better than serum B2M in detecting reduced renal function. Because of its large intraindividual variation, serial serum cystatin C estimation was very poor in detecting reduced renal function.


2008 ◽  
Vol 24 (4) ◽  
pp. 1157-1161 ◽  
Author(s):  
S. Song ◽  
M. Meyer ◽  
T. R. Turk ◽  
B. Wilde ◽  
T. Feldkamp ◽  
...  

2016 ◽  
Vol 20 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Rajeev Ranjan ◽  
Anjana Singh

ABSTRACT Background Glomerular endotheliosis is an essential component in the pathophysiology of gestational hypertension (GH) and preeclampsia (PE) which results in renal dysfunction. This is not always detected by routine renal function tests, such as serum creatinine, urea, and uric acid. Cystatin C, an endogenous cysteine protease inhibitor, is completely absorbed by renal tubules and has been shown to be an ideal marker of glomerular filtration rate (GFR), which needs to be evaluated in assessing renal dysfunction occurring in GH and PE. Aims The present study is designed to evaluate serum cystatin C levels in normal pregnancy, GH, and PE and compare its efficacy with traditional renal function tests. Materials and methods In this prospective cross-sectional study, 75 subjects enrolled, comprised of 25 subjects each of normal pregnancy, GH, and PE. Serum cystatin C, blood urea, serum creatinine, serum uric acid, and urinary protein/creatinine ratio were estimated in all subjects prior to delivery. Results All renal parameters including cystatin C were significantly raised in GH and PE compared with control group. However, only serum cystatin C level (and no other renal parameters) was significantly higher in PE group compared with GH group. Area under the curve for cystatin C was maximum (0.917) compared with other parameters. Cystatin C had a higher sensitivity and specificity than other conventional markers. Conclusion Serum cystatin C is a better marker of renal dysfunction in hypertensive pregnancies. How to cite this article Singh A, Gupta M, Ranjan R, Saini V, Gupta SK. Cystatin C is a Better Marker of Renal Dysfunction in Hypertensive Pregnancies. Indian J Med Biochem 2016; 20(1):21-27.


2020 ◽  
Author(s):  
Mitsuhiro Kawano ◽  
Akikatsu Nakashima ◽  
Shigeto Horita ◽  
Takahiro Matsunaga ◽  
Ryo Inoue ◽  
...  

Abstract Background This study aimed to clarify the factors underlying the discrepancy that has been noted between estimated glomerular filtration ratio (eGFR) measured using serum creatinine (Cr) and eGFR using serum cystatin C (CysC) in patients with rheumatoid arthritis (RA) and to identify those patients whose renal function should be evaluated using CysC.Methods We retrospectively evaluated clinical features, disease activity, radiological grading, and co-morbidities (diabetes mellitus, hypertension, dyslipidemia) in 238 RA patients. eGFR using serum creatinine (eGFR-Cr) and eGFR using serum cystatin C (eGFR-CysC) were calculated using the new Japanese coefficient-modified Modification of Diet in Renal Disease study equation. To clarify the cause(s) of differences of 20% or more between the two eGFRs, we divided our RA patients into Group A (eGFR-Cr/eGFR-CysC ≥ 1.2), with eGFR-Cr more than 20% higher than eGFR-CysC, and Group B (eGFR-Cr/eGFR-CysC < 1.2), and compared various clinical parameters between them.Results Forty-five patients (18.9%) were assigned to Group A, and 193 (81.1%) to Group B. Group A were older (73.8 ± 12.5 vs 63.2 ± 13.6 years), and had a longer disease duration (17.7 ± 14.0 vs 10.4 ± 9.5 years), lower body mass index (BMI) (20.0 ± 2.9 vs 22.4 ± 3.6 kg/m2), higher frequencies of hypertension and diabetes mellitus (55.6% vs 30.1% and 35.6% vs 11.0%, respectively), higher DAS28-ESR (3.1 ± 1.3 vs 2.6 ± 1.0), lower hemoglobin (Hb) (11.8 ± 1.8 vs 12.8 ± 1.4 g/dl), lower creatine kinase (CK) (63.9 ± 36.0 vs 92 ± 79 IU/L), higher frequency of Steinbrocker stage 4 (46.7% vs. 15.3%), and a lower frequency of nonsteroidal anti-inflammatory drugs (NSAID) use (13.3% vs 30.6%), all significantly (p < 0.01) by a univariate analysis. BMI (Odds Ratio [OR] 0.820, 95% confidence interval [CI] 0.675–0.996), Hb (OR 0.633, 95% CI 0.433–0.926), CK (OR 0.773 per 10 units, 95% CI 0.644–0.933), NSAID use (OR 0.099, 95% CI 0.020–0.494), diabetes mellitus (OR 6.024, 95% CI 1.508–24.390) and stage 4 Steinbrocker radiological grade (OR 10.309, 95% CI 2.994–35.714) were identified as independent relevant factors for Group A by a multifactorial analysis.Conclusion Renal function in RA patients with low BMI, diabetes, anemia and low CK may be overestimated using eGFR-Cr alone, and such patients need to be evaluated using eGFR-CysC.


Author(s):  
M.P. De Scally ◽  
A.L. Leisewitz ◽  
R.G. Lobetti ◽  
P.N. Thompson

Pigmented serum, usually due to free haemoglobin and/or bilirubin, is a common finding in dogs with babesiosis, resulting in interference with all biochemical tests that rely on photochemistry. This is particularly true of urea and creatinine determinations, complicating the diagnosis of acute renal failure, which is a serious complication of babesiosis. A disproportionately raised serum urea concentration of unknown origin occurs in severely anaemic canine babesiosis patients and gives rise to an increased serum urea:creatinine ratio. The assay for cystatin-C, an excellent measure of glomerular filtration rate, is unaffected by free serum haemoglobin, and due to its different intrinsic origins, is free of influence by the metabolic derangements and organ pathology, other than renal disease, encountered in canine babesiosis. Serum cystatin-C was used to compare the concentrations of serum urea and serum creatinine in dogs with the severely anaemic form of canine babesiosis as well as a canine babesiosis-free reference group. Mean serum urea and mean serum urea:creatinine ratio were significantly elevated in the babesia-infected group relative to the reference population in this study. Mean serum creatinine and mean serum cystatin-C were within the reference ranges. Therefore an elevated urea:creatinine ratio in canine babesiosis in the presence of a normal serum creatinine concentration is considered to be caused by an elevated serum urea concentration and is most likely of non-renal origin. Serum creatinine was therefore as specific a measure of renal function as serum cystatin-C in canine babesiosis in this study. The sensitivity of serum creatinine as a measure of renal function was not established by this study. Serum urea, however, proved to be of little use compared to serum cystatin-C and serum creatinine. Serum urea should therefore not be used to diagnose renal failure in canine babesiosis.


2018 ◽  
Vol 4 (1) ◽  
pp. 3-12
Author(s):  
Md Anwarul Haque Faraji ◽  
Mohammed Rashed Anwar ◽  
Dilip Kumar Debnath ◽  
Md Babrul Alam ◽  
Syed Mahbub Morshed ◽  
...  

Background: Cystatin C is being considered as a potential replacement for serum creatinine as a filtration marker.Objectives: This present study was conducted to determine the validity of Cystatin C as a renal function test and to compare the Cystatin C and serum creatinine level between the CKD cases and person not having CKD.Methodology: The present case control study was conducted in the department of Nephrology of Dhaka Medical College Hospital during the period of January 2009 to December 2009 with the aim to find out the serum Cystatin C as diagnostic markers of chronic kidney disease. In the present study total 100 respondents were included. Among them 50 were CKD patients and another 50 were without CKD. Results: It was an age and sex matched study. Out of 50 patients with CKD, 29 (58.0%) were in the stage IV followed by 15 (30.0%) were in the stage III and rest 6 (12.0%) were in the stage V. In CKD group 31 (62.0%) had glomerulonephritis, 18 (36.0%) had HTN, 11 (22.0%) had DM and 3 (6.0%) had obstructive uropathy.  In without CKD group 9 (18.0%) had HTN, 6 (12.0%) had DM. Mean±SD of Serum Creatinine in CKD and without CKD groups were 5.73±2.69 and 0.85±0.11mg/dl respectively. Mean±SD of Serum Cystatin C in CKD and without CKD groups were 3.59±1.21 and 0.71±0.09 mg/dl respectively. In all patients sensitivity of Cystatin C to diagnose CKD was 100.0% and specificity also100.0%. Sensitivity of serum creatinine to diagnose CKD was 88.0% and specificity was 100.0%.Conclusions: Cystatin C proved more reliable than creatinine and was comparable to plasma creatinine and Cockcroft-Gault estimation. Serum Cystatin C had higher diagnostic accuracy with high sensitivity and specificity to detect renal function and is a reliable marker of renal function. Journal of Current and Advance Medical Research 2017;4(1):3-12


2013 ◽  
Vol 4 (1) ◽  
pp. 16-20 ◽  
Author(s):  
TS Shima ◽  
A Khatun ◽  
F Yeasmin ◽  
S Ferdousi ◽  
K Kirtania ◽  
...  

Serum cystatin C is a new promising marker of renal function. The aim of this study was to analyze serum cystatin C as a better predictor of renal function in diabetic nephropathy. In 60 diagnosed diabetic patients, serum cystatin C and serum creatinine were assessed. Glomerular filtration rate was estimated based on the cystatin C concentration according to Cockcroft- Gault formula and based on serum creatinine concentration according to Larsson formula. DTPA-GFR (Diethylenetriamene pentaacetate Renogram) was done as reference standard. The cross tabulation of DTPA-GFR was done with eGFR- creatinine and eGFRcystatin C. The calculated sensitivity, specificity and accuracy of eGFR- creatinine were 85%, 87.2% and 85% respectively. The eGFR- cystatin C showed higher sensitivity, specificity and accuracy than eGFR- creatinine in studied diabetic subjects. The cystatin C showed more significant correlation, r=0.78, p<0.001 than serum creatinine, r=0.59, p<0.001 with DTPA-GFR in diabetic patients. This study demonstrates that serum cystatin C may be used for early prediction for renal function impairment in diabetic kidney disease. DOI: http://dx.doi.org/10.3329/bjmb.v4i1.13777 Bangladesh J Med Biochem 2011; 4(1): 16-20


1998 ◽  
Vol 44 (7) ◽  
pp. 1535-1539 ◽  
Author(s):  
Brian G Keevil ◽  
Eric S Kilpatrick ◽  
Simon P Nichols ◽  
Paul W Maylor

Abstract To assess the inherent potential for detecting mild to moderate reductions in glomerular filtration rate, this study determined the biological variability of serum cystatin C and creatinine in 12 healthy subjects. After accounting for analytical variation, interindividual variance accounted for 93% and intraindividual variance accounted for 7% of serum creatinine biological variation. As such, to lie outside the assay reference interval, some subjects must exceed 13 SD from their usual mean value, whereas in others, a change of only 2 SD would be sufficient. For cystatin C, interindividual variation explained 25% and intraindividual variance explained 75% of biological variability. Therefore, the upper limit of the population reference interval for cystatin C is seldom more than 3–4 SD from the mean value of any healthy individual. The critical difference for sequential values significant at P ≤0.05 was calculated as 37% for serum cystatin C and 14% for serum creatinine. We conclude that cystatin C is potentially a better marker for detecting impaired renal function than serum creatinine, but serum creatinine is probably still the better marker for detecting temporal changes of renal function in individuals with established renal disease.


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