scholarly journals Improved Prediction of Decreased Creatinine Clearance by Serum Cystatin C: Use in Cancer Patients before and during Chemotherapy

2000 ◽  
Vol 46 (2) ◽  
pp. 193-197 ◽  
Author(s):  
Borut Štabuc ◽  
Levin Vrhovec ◽  
Mirna Štabuc-Šilih ◽  
Tomaž Edvard Cizej
Keyword(s):  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Cancer Patients ◽  
Cystatin C ◽  
Stepwise Regression ◽  
Roc Analysis ◽  
Cysteine Protease Inhibitor ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Turbidimetric Immunoassay

Abstract Background: Serum cystatin C, a cysteine protease inhibitor, has been suggested as a new marker of glomerular filtration rate (GFR). This study explored the possibility of replacing the creatinine clearance (CrCl) estimation of GFR with cystatin C in early detection of renal impairment in cancer patients on chemotherapy. Methods: Serum creatinine and cystatin C concentrations as well as 24-h CrCl were determined simultaneously in 72 cancer patients. Among them, 60 were treated with combined chemotherapy with cisplatin (CDDP). Creatinine was determined enzymatically with a spectrophotometric method. Serum cystatin C was determined by a particle-enhanced turbidimetric immunoassay. Results: Cystatin C and creatinine correlated significantly (P = 0.001) with CrCl. The correlation was significantly better for cystatin C than creatinine (r = 0.84 vs 0.74; P = 0.01). Stepwise regression analysis identified no differences for the correlations between cystatin C and CrCl in patients with or without metastases (r = 0.82 and 0.84, respectively) as well as before treatment and before the fourth cycle of chemotherapy (r = 0.70 and 0.75, respectively). A cystatin C cutoff concentration of 1.33 mg/L had 87% sensitivity and 100% specificity for detecting CrCl <78 mL/min. ROC analysis indicated that cystatin C was superior to serum creatinine for predicting CrCl <78 mL/min (P <0.04). Conclusions: Serum cystatin C is superior to serum creatinine for detection of decreased CrCl and potentially for the estimation of GFR in cancer patients independent of the presence of metastases or chemotherapy.

Cystatin C improves the detection of mild renal dysfunction in older patients

2003 ◽  
Vol 40 (6) ◽  
pp. 648-655 ◽  
Author(s):  
Shelagh E O'Riordan ◽  
Michelle C Webb ◽  
Helen J Stowe ◽  
David E Simpson ◽  
Madhu Kandarpa ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Older People ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Older Patients ◽  
Filtration Rate ◽  
Serum Cystatin C ◽  
Serum Cystatin

Background: Conventional estimates of glomerular dysfunction, including serum creatinine and creatinine clearance, are inadequate in older people. In this study we have compared the diagnostic accuracy of a novel test of kidney disease, cystatin C, against these markers in older patients with a range of renal function. Methods: Fifty-three patients (mean age 79.6 years, range 69-92 years) with a variety of medical diagnoses were recruited via outpatient clinics. Exclusion criteria included active rheumatoid disease, known current malignancy, renal replacement therapy/renal transplantation and cognitive impairment. 51Cr-EDTA was used as the reference method against which the other markers of glomerular filtration rate were compared using regression analyses. Results: The best fit with glomerular filtration rate was given by Cockcroft and Gault calculated clearance ( R2 = 0.83), followed by serum cystatin C ( R2 = 0.79), serum creatinine ( R2 = 0.76) and creatinine clearance ( R2 = 0.73). The accuracy for glomerular filtration rate prediction was poor for all markers. Serum cystatin C detected nearly all patients with mild renal impairment whereas serum creatinine only detected half of these cases. Regression modelling predicted that the upper limit of normal for serum cystatin C would be exceeded as glomerular filtration rate fell below 64 mL/min/1.73 m2, compared with 44 mL/min/1.73 m2 for serum creatinine. Conclusion: Serum cystatin C is a simple and sensitive screening test for kidney dysfunction in older people.

scholarly journals Cystatin C for estimation of glomerular filtration rate in patients with spinal cord injury

2003 ◽  
Vol 40 (4) ◽  
pp. 364-368 ◽  
Author(s):  
Margaret A. Jenkins ◽  
Douglas J. Brown ◽  
Francesco L. Ierino ◽  
Sujiva I. Ratnaike
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Cystatin C ◽  
Filtration Rate ◽  
Surrogate Marker ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Cord Injury

Background: Serum creatinine is not a satisfactory marker of glomerular filtration rate (GFR) in patients with spinal cord injury (SCI) who have varying degrees of muscle atrophy. In contrast to serum creatinine, serum cystatin C, a 13-kDa protein, is not affected by muscle mass and is therefore potentially a useful marker of GFR in patients with SCI. In addition, cystatin C is not dependent on sex or age and is not secreted by the renal tubule. Aim: We assessed serum cystatin C as a surrogate marker of GFR in SCI patients. Methods: Cystatin C was analysed using a particle-enhanced immunonephelometric assay (Dade Behring) in serum samples sent for routine measurement of creatinine (64 patients) and creatinine clearance (27 patients) from patients in the Spinal Unit of the Austin Health. We compared these results with serum cystatin C of 57 non-SCI patients who had had a creatinine clearance measurement during the study period. Results: In patients with SCI, the reciprocal of cystatin C had a stronger correlation (r = 0·48, P<0·01) with creatinine clearance than the reciprocal of serum creatinine (r = 0·25, P<0·19). Further, the value of serum creatinine was much lower for a given creatinine clearance in SCI patients than in non-SCI patients; the serum cystatin C concentrations were equivalent. Conclusion: The serum cystatin C is a convenient and more reliable surrogate marker of GFR than serum creatinine and will enable early detection of renal impairment. We need to confirm this finding with a larger study, including comparison with an accepted gold standard for GFR.

scholarly journals Correlation of Serum Cystatin C with Glomerular Filtration Rate in Patients Receiving Platinum-Based Chemotherapy

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Ernesta Cavalcanti ◽  
Vittoria Barchiesi ◽  
Dionigio Cerasuolo ◽  
Flaviano Di Paola ◽  
Monica Cantile ◽  
...  
Keyword(s):  
Renal Failure ◽  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Cancer Patients ◽  
Cystatin C ◽  
Roc Curve ◽  
Filtration Rate ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Platinum Based Chemotherapy

Objectives. Serum cystatin C seems to be an accurate marker of glomerular filtration rate (GFR) compared to serum creatinine. The aim of this work was to explore the possibility of using serum cystatin C instead of serum creatinine to early predict renal failure in cancer patients who received platinum based chemotherapy.Design and Methods. Serum creatinine, serum cystatin C concentrations, and GFR were determined simultaneously in 52 cancer patients received carboplatin-based or cisplatin-based chemotherapy. Serum creatinine was assayed on Cobas C6000-Roche, serum cystatin C assay was performed on AIA 360-Tosoh, and GFR was determined in all patients, before the first cycle of chemotherapy and before the subsequent administrations.Results. In the overall series, for the prediction of a fall of GFR < 80 mL/min/1.73 m2, the AUC of the ROC curve for cystatin C was 0,667 and the best threshold was 1.135 mg/L (sensitivity 90.5%, specificity 61.1%). For a GFR fall < 60 mL/min/1.73 m2, the AUC of ROC curve for cystatin C was 74.3% and the best threshold was 1.415 mg/L (sensitivity 66.7%, specificity 73.2%).Conclusions. Baseline cystatin C values were not able to predict renal failure during subsequent treatment. In conclusion, serum cystatin C is not a reliable early marker to efficiently predict renal failure in patients receiving chemotherapy.

scholarly journals Prospects of using cystatin c as an early predictor of diabetic nephropathy

2019 ◽  
Vol 68 (3) ◽  
pp. 15-24 ◽  
Author(s):  
Natalia V. Borovik ◽  
Maria I. Yarmolinskaya ◽  
Olga B. Glavnova ◽  
Alyona V. Tiselko ◽  
Svetlana V. Suslova ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Creatinine Level ◽  
Cystatin C ◽  
Glycated Hemoglobin ◽  
Study Groups ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Clearance Test

Hypothesis/aims of study. Using early non-invasive markers of diabetic nephropathy (DN) in clinical practice is important to early start of nephroprotective therapy and leads to improving the quality of life, while decreasing disability and mortality of diabetic patients. The aim of the study was to estimate the potential of using serum cystatin C and glomerular filtration rate (GFR) calculated by CKD-EPIcys and CKD-EPIcr-cys equations for an early diagnosis of DN in type 1 diabetic (T1D) women who were planning pregnancy or were in the I trimester of pregnancy. Study design, materials, and methods. 47 T1D women were examined, of whom 25 individuals were pregnant and 22 ones were planning pregnancy. In all patients, glycated hemoglobin and serum cystatin C levels were determined, GFR was estimated by the creatinine clearance test, MDRD, CKD-EPIcr, CKD-EPIcys, and CKD-EPIcr-cys equations, with diabetes training done. Results. The pregnant group and the planning pregnancy group were distinguished by glycated hemoglobin (p = 0.001), serum creatinine (p = 0.001), and GFR estimated by the creatinine clearance test (р = 0.017), CKD-EPIcr (р = 0.005), and CKD-EPIcr-cys (р = 0.046) equations. There was no difference in urinary creatinine, serum cystatin C, and GFR estimated by CKD-EPIcys equation and daily urinary protein excretion between the study groups. Most pregnant women (87.5%) were in stage C1 and only 12,5% in stage C2 as determined by estimated GFR using the CKD-EPIcr formula, which was significantly different compared to the planning pregnancy group, where the percentage of women in stages C1 and C2 was comparable (р = 0.002). In addition, most pregnant patients were in stage C1, while most of the patients planning pregnancy were referred to stage C2 by GFR estimated by CKD-EPIcysequation. Stage C3a was diagnosed in the both study groups only when CKD-EPIcys equation for GFR estimation was used. Most women from both groups were in stage C1 when GFR was estimated by the creatinine clearance test, the percentage ratio of patients in stages C1 and C2 in both groups being comparable. Conclusion. Our results demonstrated that serum cystatin C and GFR estimation by CKD-EPIcys equation could improve nephropathy diagnostic accuracy among T1D patients with a normal serum creatinine level and intact GFR based on creatinine level.

scholarly journals Cystatin C based eGFR - for early detection of diabetic kidney disease

2019 ◽  
Vol 7 (9) ◽  
pp. 3402
Author(s):  
Sudarshan N. Shelke ◽  
Jyoti S. Tele
Keyword(s):  
Kidney Disease ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Cystatin C ◽  
Diabetic Kidney Disease ◽  
Diabetic Patients ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Diabetic Kidney ◽  
Urine Creatinine

Background: Diabetic kidney disease is the leading cause of premature death in young diabetic patients. Detection of diabetic kidney disease as early as possible in the disease process currently offers the best chance of delaying or possibly preventing progression to end-stage renal disease. The present study was aimed to evaluate utility of serum cystatin C based eGFR for early diagnosis of diabetic kidney disease.Methods: Diagnosed patients of type 2 diabetes mellitus having frank proteinuria were excluded. Patients without proteinuria were tested for microalbuminuria.  50 patients having microalbuminuria were tested for 24 hour urine creatinine, serum creatinine and serum cystatin C. Both cystatin C based eGFR and eGFR by Cockcroft and Gault equation were compared with standard GFR by 24 hour urine Creatinine clearance respectively.Results: There was statistically significant positive correlation between cystatin C based eGFR and standard GFR by 24 hr Creatinine clearance (r=0.87). For eGFR by Cockcroft-Gault equation, it was 0.36 (r=0.36).Conclusions: The results of this study suggest that serum cystatin C based eGFR  measurement is a useful, practical tool for the evaluation of renal involvement in the course of diabetes. As serum creatinine values are affected by many factors like age, sex, muscle mass and diet, serum cystatin C based eGFR estimation offers a hope that diabetic kidney disease can be well prevented with appropriate interventions.

scholarly journals Adult Reference Ranges for Serum Cystatin C, Creatinine and Predicted Creatinine Clearance

2000 ◽  
Vol 37 (1) ◽  
pp. 49-59
Author(s):  
Hazel Finney ◽  
David J Newman ◽  
Christopher P Price
Keyword(s):  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Cystatin C ◽  
Blood Donors ◽  
Reference Range ◽  
Reference Interval ◽  
Reference Intervals ◽  
Reference Ranges ◽  
Serum Cystatin C ◽  
Serum Cystatin

Serum cystatin C measurement has been previously shown by ourselves and others to be a better indicator of changes in glomerular filtration rate (GFR) than serum creatinine. However, the available literature on reference values for cystatin C concentration remains surprisingly sparse; we thus set out to determine an adult reference range. Blood was taken from 309 healthy blood donors and creatinine and cystatin C concentrations were measured using commercially available automated methodologies. In addition, predicted creatinine clearances were calculated using the Cockcroft and Gault formula. The 95% reference intervals for creatinine, predicted creatinine clearance and cystatin C for all blood donors, regardless of gender, were 68–118 μmol/L, 58–120 ml/min/1·73 m2 and 0·51–0·98 mg/L, respectively. For women, the intervals were 68–98 μmol/L, 60–119 ml/min/1·73 m2 and 0·49–0·94 mg/L; for men, they were 78–123 μmol/L, 57–122 ml/min/1·73 m2 and 0·56–0·98 mg/L. The mean 95% reference interval for cystatin C in all donors under 50 years of age was 0·53–0·92 mg/L; for those over 50 years of age it was 0·58–1·02 mg/L. The small difference between male and female ranges meant that a single reference range for cystatin C could be established for all adults under 50 years of age without adjustment for body surface area. Serum cystatin C measurement offers a simpler and more sensitive screening test than serum creatinine for early changes in GFR.

scholarly journals PERBANDINGAN CYSTATIN C DENGAN PARAMETER UJI FUNGSI GINJAL LAINNYA

2018 ◽  
Vol 14 (1) ◽  
pp. 16
Author(s):  
Pusparini .
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Cystatin C ◽  
Normal Serum ◽  
Control Group ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Failure Group

The Gold standard for the evaluation of the glomerular filtration rate (GFR) is inulin clearance, but in widespread use is prevented by several technical difficulties. The most commonly used marker for GFR is serum creatinine alone or in conjunction with 24 hoururine collection for determination of creatinine clearance, but these marker have several limitation include following: influence of age,sex, muscle mass on endogenous creatinine production, dietary intake and the difficulties of 24 hour urine collection. Fifty six patientwith chronic renal failure and 53 control had analyze for serum creatinin, creatinine clearance and serum cystatin C. The chronic renalfailure patient aged range from (64 + 14.54) year and the control group aged range from (62.5+ 17.5) year. The proposed of this studywas to compare cystatin C with another parameter for renal function test. The result showed that in control group serum creatinineand creatinine clearance had influence with age, sex and body mass index, but serum cystatin C was not. The normal value of cystatinC was (0.85 + 0.13) mg/dL In chronic renal failure group there were significant correlation between level of cystatin C with creatininclearance (p = 0.000, r = 0.69). The level of cystatin C increase higher than serum creatinine in patient with low clearance creatinine.In control group we were determined low creatinine clearance in patient with normal serum creatinine and cystatin C.

Serum Cystatin C Is a Better Marker for Renal Function Than Serum Creatinine in Children with Sickle Cell Disease.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3774-3774
Author(s):  
Ofelia A. Alvarez ◽  
Dale Wright ◽  
Gabriela Lopez ◽  
Gaston Zilleruelo
Keyword(s):  
Sickle Cell Disease ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Sickle Cell ◽  
Cystatin C ◽  
Renal Tubules ◽  
Cell Disease ◽  
Serum Cystatin C ◽  
Estimated Gfr ◽  
Serum Cystatin

Abstract High serum creatinine is a late manifestation for patients (pts) with sickle cell disease (SCD) who develop severe renal dysfunction, because creatinine is secreted by the renal tubules. Serum cystatin C is a cysteine proteinase inhibitor, that is produced by all nucleated cells in the body, does not undergo tubular secretion, and reflects glomerular filtration rate (GFR)accurately. Normal levels for serum cystatin C are 0.5–1.3 mg/L for children 1–17 years, and 0.5–1 mg/L for adults. The purpose of this study was to compare serum cystatin C and serum creatinine as markers of GFR in children with SCD with different levels of albuminuria. Twenty pts (mean age 16.4, range 9–21 years) had serum creatinine, serum cystatin, and 24-hour urine for creatinine clearance. Pts with normoalbuminuria (N=11) had mean serum creatinine of 0.55±0.14 mg/L, creatinine clearance of 168±36 ml/min/1.73m2, normal serum cystatin C 0.78±0.16 mg/L, and normal estimated GFR derived from cystatin of 106±27 ml/min/1.73m2. In contrast, pts with proteinuria (N=4) had higher or abnormal serum cystatin C (mean 1.25 ±0.34, range 0.9–1.7 mg/L) and reduced estimated GFR (mean 59±21, range 35–85) consistent with poor kidney function; nevertheless, the serum creatinine (0.7±0.2) and creatinine clearance remained normal (125±27). Pts with only microalbuminuria (N=5) maintained normal levels of cystatin C and estimated GFR by cystatin. We conclude that serum cystatin C discriminated better for kidney dysfunction than serum creatinine and creatinine clearance with significantly different values between patients with normoalbuminuria and macroalbuminuria (p=0.038). More studies are warranted in order to investigate further the value of serum cystatin C in the monitoring of patients with SCD and albuminuria.

scholarly journals Is serum cystatin C the marker of choice to predict glomerular filtration rate in paediatric patients?

2003 ◽  
Vol 40 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Hans L. Willems ◽  
Luuk B. Hilbrands ◽  
John F. van de Calseyde ◽  
Leo A.H. Monnens ◽  
Dorine W. Swinkels
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Inulin Clearance ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Endogenous Creatinine Clearance

Background: It has been suggested that serum cystatin C (cyst-C) concentration provides a better indication of changes in glomerular filtration rate (GFR) than does serum creatinine concentration. Methods: Because of conflicting results as to the usefulness of cyst-C, we compared the GFRs calculated from serum cyst-C, inulin clearance and endogenous creatinine clearance in children. GFRs calculated from cystatin concentration, inulin clearance following a single injection and endogenous creatinine clearance using Jaffé and enzymic methods were compared in 66 children (1·3-21·9 years) with a variety of renal disorders. Receiver operating curve analysis was used to determine the cut-off value that would give the best discrimination between normal and decreased GFR. Results: The serum cyst-C concentration ranged from 0·66 to 7·61 mg/L (median 1·94). Serum creatinine Jaffé concentration (creat-J) ranged from 38 to 871 µmol/L (median 105) and creatinine enzymatic concentration (creat-E) ranged from 28 to 862 µmol/L (median 126). The linear correlation coefficient ( R) of 1/cyst-C versus GFR ( R = 0·937) did not differ from either that of 1/creat-J versus GFR ( R = 0·918) or that of 1/creat-E versus GFR ( R = 0·901). These coefficients had overlapping confidence intervals. The areas under the curve for cyst-C, creat-J and creat-E were 0·967, 0·977 and 0·924, respectively, and were not significantly different from each other. For cyst-C, the optimal cut-off was 1·1 mg/L. Conclusions: Serum cyst-C is equivalent to creat-J and creat-E as a marker for estimating the GFR in the paediatric population studied.

Sign in / Sign up

Export Citation Format

Share Document