Mild renal dysfunction as a non-traditional cardiovascular risk factor?—Association of cystatin C-based glomerular filtration rate with flow-mediated vasodilation

Introduction: Pathophysiological interaction between the heart and kidneys represents the basis for clinical entities called cardiorenal syndromes. The purpose of the study was to assess the relations between acute and chronic cardiorenal syndromes and biomarkers [advanced oxidation protein products, brain natriuretic peptide, malondialdehyde, xanthine oxidoreductase (XOD), xanthine oxidase, xanthine dehydrogenase, interleukin 8, cystatin C, plasminogen activator inhibitor-1, high-sensitive troponin T, C-reactive protein and glomerular filtration rate, measured by the Modification of Diet in Renal Disease (MDRD) formula], to hypothesize biomarkers that might provide a prompt identification of acute or chronic cardiorenal syndromes, and to distinguish acute versus chronic types of these syndromes. Methods: A total of 114 participants were enrolled in this study, i.e. 79 patients divided into subgroups of acute and chronic cardiorenal syndromes and 35 volunteers. Results: Nonadjusted odds ratio (OR) showed that there was a significant risk for acute cardiorenal syndrome with increased XOD activity (p = 0.037), elevated cystatin C concentration (p = 0.038) and MDRD (p = 0.028). Multivariable adjusted OR, on the other hand, revealed that only glomerular filtration rate measured by the MDRD formula had a significance for acute cardiorenal syndrome (p = 0.046). Nonadjusted OR showed a significant risk for chronic cardiorenal syndrome only in elderly (p = 0.002). Multivariable adjusted OR exhibited that age was the only risk factor for chronic cardiorenal syndrome (p = 0.012). Conclusion: Cystatin C, glomerular filtration rate measured by the MDRD equation and XOD were independent risk factors for acute cardiorenal syndrome, while age remained an independent risk factor for chronic cardiorenal syndrome. When comparing ORs of evaluated parameters, the highest significance for acute cardiorenal syndrome was plasma concentration of cystatin C.

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Cystatin C-calculated Glomerular Filtration Rate—A Marker of Early Renal Dysfunction in Patients With Neuropathic Bladder

Urology ◽

10.1016/j.urology.2016.08.011 ◽

2017 ◽

Vol 100 ◽

pp. 213-217 ◽

Cited By ~ 7

Author(s):

Pankaj P. Dangle ◽

Omar Ayyash ◽

Audry Kang ◽

Carlton Bates ◽

Janelle Fox ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Renal Dysfunction ◽

Glomerular Filtration ◽

Cystatin C ◽

Filtration Rate ◽

Neuropathic Bladder

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Low glomerular filtration rate as an associated risk factor for sarcopenic muscle strength: is creatinine or cystatin C-based estimation more relevant?

The Aging Male ◽

10.1080/13685538.2016.1225032 ◽

2016 ◽

Vol 20 (2) ◽

pp. 110-114 ◽

Cited By ~ 7

Author(s):

Asli Tufan ◽

Fatih Tufan ◽

Timur Selcuk Akpinar ◽

Birkan Ilhan ◽

Gulistan Bahat ◽

...

Keyword(s):

Risk Factor ◽

Glomerular Filtration Rate ◽

Muscle Strength ◽

Glomerular Filtration ◽

Cystatin C ◽

Filtration Rate

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Serum cystatin C unmasks renal dysfunction in cirrhosis and performs better in estimation of glomerular filtration rate

Saudi Journal of Kidney Diseases and Transplantation ◽

10.4103/1319-2442.308341 ◽

2020 ◽

Vol 31 (6) ◽

pp. 1320

Author(s):

RemiGeorge Thomas ◽

Balaraman Velayudham ◽

C Vasudevan ◽

RP Senthilkumar ◽

Thirumalvalavan ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Renal Dysfunction ◽

Glomerular Filtration ◽

Cystatin C ◽

Filtration Rate ◽

Serum Cystatin C ◽

Serum Cystatin

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Cystatin C - more than the marker of the glomerular filtration rate

Medicinski pregled ◽

10.2298/mpns1506173c ◽

2015 ◽

Vol 68 (5-6) ◽

pp. 173-179 ◽

Cited By ~ 7

Author(s):

Velibor Cabarkapa

Keyword(s):

Glomerular Filtration Rate ◽

Cardiovascular Risk ◽

Glomerular Filtration ◽

Kidney Function ◽

Cystatin C ◽

Filtration Rate ◽

The Elderly ◽

Serum Cystatin C ◽

Blind Area

Introduction. Cystatin C is one of biomarkers that meet the conditions necessary for an endogenous substance to be a marker of the glomerular filtration rate. Cystatin C - Properties. Cystatin C is produced in the nucleated cells in a constant amount, and its serum concentration does not depend on muscle mass and protein intake. The catabolism of cystatin C is mostly done in the kidneys. Determination of Cystatin C Level. Cystatin C may be determined in the serum, plasma, capillary blood and urine. The laboratory methods which are mainly used to determine its level are nephelometric and turbidimetric immunoassays. Cystatin C as a Marker of Glomerular Filtration Rate. Cystatin C is superior to creatinine as a marker of kidney function, especially in the early stages of chronic kidney disease. Several formulas are available for calculating the glomerular filtration rate from serum cystatin C. Cystatin C in Various Physiological/Pathophysiological Conditions. The level of cystatin C should be interpreted carefully because there are factors that can affect its level regardless of the renal function (thyroid dysfunction, glucocorticoids use, malignancies etc.). Higher cystatin C concentrations in general population are associated with an increased cardiovascular risk, as well as with preeclampsia in pregnant women. Conclusion. The significant advantages of cystatin C as a kidney function marker are its use in the creatinine ?blind? area, in pediatric and the elderly population. In addition, cystatin C could be used as a marker for cardiovascular risk assessment, in predicting and detecting preeclampsia, in patients with malignant diseases, etc.

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Cystatin C and Cardiovascular Risk

Clinical Chemistry ◽

10.1373/clinchem.2009.128397 ◽

2009 ◽

Vol 55 (11) ◽

pp. 1932-1943 ◽

Cited By ~ 132

Author(s):

Nevio Taglieri ◽

Wolfgang Koenig ◽

Juan Carlos Kaski

Keyword(s):

Glomerular Filtration Rate ◽

Cardiovascular Risk ◽

Kidney Disease ◽

Glomerular Filtration ◽

Cystatin C ◽

Cardiovascular Events ◽

Filtration Rate ◽

Systemic Hypertension ◽

Clinical Scenarios

Abstract Background: Patients with chronic kidney disease (CKD) are at high risk for developing cardiovascular disease (CVD) and cardiovascular events. Cystatin C, a protease inhibitor synthesized in all nucleated cells, has been proposed as a replacement for serum creatinine for the assessment of renal function, particularly to detect small reductions in glomerular filtration rate. Content: This report presents a review of the role of cystatin C as a predictor of cardiovascular risk. Summary: Patients with higher circulating cystatin C concentrations appear to have an increased cardiovascular risk profile, i.e., they are older and have a higher prevalence of systemic hypertension, dyslipidemia, documented CVD, increased body mass index, and increased concentrations of C-reactive protein. Prospective studies have shown, in various clinical scenarios, that patients with increased cystatin C are at a higher risk of developing both CVD and CKD. Importantly, cystatin C appears to be a useful marker for identifying individuals at a higher risk for cardiovascular events among patients belonging to a relatively low-risk category as assessed by both creatinine and estimated glomerular filtration rate values. Of interest, elastolytic proteases and their inhibitors, in particular cystatin C, have been shown to be directly involved in the atherosclerotic process. Increased concentrations of cystatin C appear to be indicative of preclinical kidney disease associated with adverse outcomes. Clinical studies involving direct glomerular filtration rate measurements are required to ascertain both the true role of this promising marker in renal disease and whether atherogenic factors like inflammation can account for increases in cystatin C concentrations, thus explaining its predictive value in CVD.

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Can cystatin C-based estimated glomerular filtration rate help to guide individualized risk factor modification programs?

IJC Heart & Vasculature ◽

10.1016/j.ijcha.2018.05.006 ◽

2018 ◽

Vol 19 ◽

pp. 100-101

Author(s):

Dominik Linz ◽

Mathias Hohl ◽

Dobromir Dobrev

Keyword(s):

Risk Factor ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Cystatin C ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Risk Factor Modification ◽

Factor Modification

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Funktsional'noe sostoyanie pochek u detey i podrostkov s ozhireniem

Obesity and metabolism ◽

10.14341/2071-8713-4953 ◽

2011 ◽

Vol 8 (2) ◽

pp. 52-55

Author(s):

L R Gaysina ◽

A I Safina ◽

Farida Vadutovna Valeeva

Keyword(s):

Diabetes Mellitus ◽

Risk Factor ◽

Glomerular Filtration Rate ◽

Cardiovascular Risk ◽

Kidney Disease ◽

Arterial Hypertension ◽

Glomerular Filtration ◽

Filtration Rate ◽

Overweight And Obesity ◽

Renal Tubular

Overweight and obesity are the most actual problems nowadays. Number of overweight patients steadily raises and duplicates every three decades. Obesity is associated with some factors of cardiovascular risk like diabetes mellitus and arterial hypertension, frequently leads to kidney disfunction. Obesity itself can result in poor renal hemodynamics, well-known risk factor of kidney disease. We studied impact of overweight and obesity in children and adolescents on renal tubular function and glomerular filtration rate.

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Glomerular Filtration Rate Estimation using Cystatin C Levels Identifies Subclinical Renal Dysfunction in Patients with Rheumatoid Arthritis

10.21203/rs.3.rs-1083387/v1 ◽

2021 ◽

Author(s):

Makoto Fukuda ◽

Naoki Sawa ◽

Hiroki Mizuno ◽

Daisuke Ikuma ◽

Rikako Hiramatsu ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Glomerular Filtration Rate ◽

Side Effects ◽

Renal Dysfunction ◽

Glomerular Filtration ◽

Cystatin C ◽

Filtration Rate ◽

Univariate Analysis ◽

Subcutaneous Fat ◽

Accurate Estimation

Abstract BackgroundMethotrexate is widely used to treat rheumatoid arthritis (RA) but can cause very serious side effects, including pancytopenia, in patients with renal impairment who have an estimated glomerular filtration rate (GFR) of <60 ml/min/1.73m2. In patients with low muscle volume such as elderly patients, GFR can be measured as higher value when calculated using serum creatinine [eGFR(cre)], so more accurate estimation using cystatin C [eGFR(cys)] is preferred.MethodWe evaluated 173 patients with RA who visited Toranomon Hospital in 2019 for factors that may contribute to the difference between eGFR(cre) and eGFR(cys) [eGFR(cre−cys)]. Activities of daily living (ADL) (walking, 1 point; using a cane, 2 points; using a wheelchair, 3 points) was added as a parameter.ResultsIn univariate analysis using Spearman's rank correlation coefficient, eGFR(cre−cys) was negatively correlated with body weight, height, body surface area (BSA), subcutaneous fat area (SFA)/BSA, albumin, and creatinine kinase, and positively correlated with age, erythrocyte sedimentation rate (ESR), and urinary protein. eGFR(cre−cys) was higher in patients who used a cane or wheelchair than those who could walk unaided. Multiple regression analysis showed that ADL and age contribute significantly to eGFR(cre−cys). ConclusionPatients using a cane or wheelchair are susceptible to the higher eGFR(cre−cys) values and overestimation of eGFR(cre), resulting in failed detect subclinical renal dysfunction. For such patients, eGFR(cys) should be evaluated to prevent serious side effects of methotrexate that are easily developed on patients with renal dysfunction.

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