SERUM CYSTATIN C VERSUS SERUM CREATININE IN THE ESTIMATION OF GLOMERULAR FILTRATION RATE IN RHABDOMYOLYSIS

2011 ◽  
Vol 37 (3) ◽  
pp. 155-157 ◽  
Author(s):  
Michael Yap ◽  
Jorge Lamarche ◽  
Alfredo Peguero ◽  
Craig Courville
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Serum Cystatin C ◽  
Serum Cystatin

scholarly journals Estimation of Glomerular Filtration Rate From Serum Cystatin C and Creatinine in Patients with Thyroid Dysfunction

2012 ◽  
Vol 31 (2) ◽  
pp. 88-93
Author(s):  
Velibor Čabarkapa ◽  
Romana Mijović ◽  
Zoran Stošić ◽  
Nikola Ćurić ◽  
Radmila Žeravica ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Thyroid Dysfunction ◽  
Newly Diagnosed ◽  
Serum Concentrations ◽  
Serum Cystatin C ◽  
Serum Cystatin

Estimation of Glomerular Filtration Rate From Serum Cystatin C and Creatinine in Patients with Thyroid DysfunctionGiven that thyroid function influences serum cystatin C and creatinine levels, the question arises as to whether it is possible to accurately estimate glomerular filtration rate (GFR) in patients with thyroid dysfunction. The objective of the study was to determine serum cystatin C and creatinine levels and estimate GFR in patients with thyroid dysfunction. The study included 32 cases with newly diagnosed hyperthyroidism and 27 cases with newly diagnosed hypothyroidism, as well as 20 healthy controls matched for sex and age with the cases. Serum concentrations of thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4), creatinine and cystatin C were measured in all study subjects. GFR was estimated using the Modification of Diet in Renal Disease (MDRD), the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and cystatin C-based equations. Serum cystatin C levels were significantly higher in hyperthyroid subjects compared to controls (1.32±0.31 vs. 0.89±0.15; p<0.01). Serum creatinine levels were significantly lower in hyperthyroid subjects compared to controls (60.6±10.2 vs. 76.4±8.6; p<0.01), and significantly higher in hypothyroid subjects compared to controls (94.5±13.2 vs. 76.4±8.6; p<0.01). GFR estimated with the MDRD equations was significantly higher in hyperthyroid subjects compared to hypothyroid subjects (101.6±20.7 vs. 64.1±11.6 mL/min/1.73m2; p<0.01). GFR estimated with the equation based on serum cystatin C was significantly lower in hyperthyroid subjects compared to hypothyroid subjects (59.2±22.1 vs. 92.1±16.0 mL/min/1.73m2; p<0.01). Although serum cystatin C is regarded a reliable marker of GFR and more sensitive than serum creatinine, it has limitations in patients with thyroid dysfunction, due to significant changes in its serum concentrations regardless of renal function. In patients with thyroid dysfunction GFR should therefore be estimated using the equations based on serum creatinine.

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 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.

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