The efficacy of cystatin C assay in the prediction of glomerular filtration rate. Is it a more reliable marker for renal failure?

2005 ◽  
Vol 43 (8) ◽  
Author(s):  
Zerrin Bicik ◽  
Talat Bahcebasi ◽  
Sevsen Kulaksızoglu ◽  
Ozlem Yavuz
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Creatinine Clearance ◽  
Cystatin C ◽  
Correlation Coefficients ◽  
Control Group ◽  
Operating Characteristics ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Receiver Operating

AbstractWe determined the sensitivity, specificity, receiver operating characteristics and correlation between cystatin C (cysC) and two widely used markers of renal function, creatinine clearance and serum creatinine, in 244 patients (84 diabetics, 84 hypertensive and 76 healthy subjects). Renal failure was defined as creatinine clearance of less than either 80 or 60mL/min. Variables were evaluated for two definitions of renal failure and compared between patient groups. Correlation coefficients with cysC were −0.87 for creatinine clearance and 0.92 for creatinine in patients with hypertension; −0.90 for creatinine clearance and 0.97 for creatinine in diabetics; and −0.61 for creatinine clearance and 0.94 for creatinine in the control group. The receiver operating characteristic curves with a cut-off value of 60mL/min were similar for creatinine and cysC, while at 80mL/min they were 0.626 for creatinine and 0.813 for cysC levels. We classified the patients into three groups with respect to creatinine clearance (1, >80mL/min; 2, 60–80mL/min; 3, <60mL/min). Mean creatinine (p<0.0001) and cysC (p<0.0001) levels were significantly different between all the groups. Sensitivity, specificity and predictive values were higher for cysC levels, particularly in diabetics and hypertensive patients. The current study suggests that cysC is preferable for detecting temporal changes in renal function in the early stages of renal insufficiency.

Screening for Personality Disorders: A Three-Item Screener From the Inventory of Interpersonal Problems (IIP-3)

2019 ◽  
Vol 33 (6) ◽  
pp. 832-845
Author(s):  
Paul A. Pilkonis ◽  
Suzanne M. Lawrence ◽  
Kelly L. Johnston ◽  
Nathan E. Dodds
Keyword(s):  
Personality Disorders ◽  
Interpersonal Problems ◽  
Self Report ◽  
Receiver Operating Characteristics ◽  
Operating Characteristics ◽  
Predictive Values ◽  
Inventory Of Interpersonal Problems ◽  
Sensitivity Specificity ◽  
Receiver Operating

To encourage screening for personality disorders (PDs), we developed (in previous work) self-report scales for PDs using the Inventory of Interpersonal Problems (IIP). The combined score from three of the scales—inter-personal sensitivity, interpersonal ambivalence, and aggression—requiring 15 items (IIP-15) did the best job of distinguishing between respondents with any versus no PD. The goals for the present work were (a) to cross-validate the IIP-15 by examining its performance using receiver operating characteristics (ROC) analyses in a new sample (N = 410), and (b) to investigate the utility of a brief three-item variant (IIP-3). The present results again documented the good operating characteristics of the IIP-15. Sensitivity, specificity, and positive and negative predictive values were all above. 70. The operating characteristics of the IIP-3 were nearly as good despite its brevity and support its use as an initial screen for PDs.

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.

scholarly journals Serum cystatin C as a measure of GFR in renal transplant patients

2003 ◽  
Vol 131 (5-6) ◽  
pp. 211-214
Author(s):  
Dijana Jovanovic ◽  
Pavle Krstivojevic ◽  
Ivana Obradovic ◽  
Vesna Djurdjevic ◽  
Radmila Blagojevic-Lazic ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Renal Transplant ◽  
Creatinine Clearance ◽  
Cystatin C ◽  
Correlation Coefficients ◽  
Control Group ◽  
Low Molecular Weight ◽  
Transplant Patients ◽  
Renal Transplant Patients ◽  
Group 2

INTRODUCTION Assessment of renal function is of great importance in clinical medicine, especially in renal transplant patients requiring frequent controls of renal function. Therefore, continuous efforts have been made in searching precise and simple method for determination of glomerular filtration rate (GFR). Serum level of cystatin C (CyC), protein of low molecular weight, has been proposed as measure of GFR, but the data of its value in renal transplant patients are scarce [8-10]. PURPOSE The aim of this study was to compare the serum levels of low molecular weight proteins CyC and ?2-microglobulin (?2-MG) with creatinine clearance, as well known measure of GFR, in renal transplant patients and control group of patients with different renal disease. PATIENTS AND METHODS The study included 36 patients divided into two groups. Group 1: 20 renal transplant patients (12 men and 8 women) aged between 22 and 63 (40.4?10.1) years with creatinine clearance from 7.1 to 77.7 ml/min. Group 2: 16 controls (5 men and 11 women) with various renal diseases, aged between 24 and 63 (41.5?12.5) years with creatinine clearance from 60.5 to 116.8 ml/min. N Latex Cystatin C and ?2-microglobulin for the Behring Nephelometer System was used in this study. Creatinine was determined with Jaffe-reaction in serum and urine. RESULTS In renal transplant patients as well as in control group of patients the significant correlation between creatinine clearance and reciprocal values of the serum CyC (rt=0.828; pt<0.001; rc=0.603; pc<0.05) and reciprocal values of the serum ?2-MG levels (rt=0.791; pt<0.001; rc=0.627 pc<0.05) was found (Graph 1). There was a slightly better correlation between creatinine clearance and reciprocal values of the serum CyC than the one between creatinine clearance and reciprocal values of the serum ?2-MG without statistical significance in renal transplant patients. There was no difference in correlation coefficients between both low molecular weight proteins and creatinine clearance in Group 2. The correlation coefficient between serum CyC and ?2-MG was r=0.839(p<0.001)in renal transplant patients and r=0.835 (p<0.05) in control group. There were no significant differences in correlation coefficients between reciprocal values of serum CyC and creatinine clearance (p=0,2043) as well as reciprocal values of serum ?2-MG and creatinine clearance (p=0.3717) between Group 1 and Group 2. DISCUSSION In renal transplant patients rapid assessment of graft function is necessary. This allows early recognition of rejection as well as differential diagnosis of different renal graft disorders. Study of Risch and co [16] suggested that serum CyC was very good marker for GFR in renal transplant patients which was confirmed by the other authors too [20-22]. During inflammatory process or other pathological conditions, especially during acute rejection or infections, CyC also provided precise assessment of GFR while creatinine clearance varied dramatically [16], Serum concentration of ?2-MG, another low molecular weight protein, also depends both on its production rate and the GFR [5,19]. Its production is dramatically different in patients with infections [5] as well as while immunosuppressive drugs are used [16], Therefore, ?2-MG is impractical as GFR marker in patients with renal transplants. So, serum CyC was considered as better marker for GFR than ?2-MG and creatinine clearance in renal transplant patients with different complications [16], In this study serum CyC was slightly better marker for GFR than ?2-MG, without statistical significance (Graph 1). Renal transplant patients, however, were in the stable condition at the time of the study. CONCLUSION Serum CyC was moderately better marker of GFR than ?2-MG in renal transplant patients when they were in the stable condition. Serum CyC and ?2-MG were the same markers of GFR in control group of patients with various renal diseases. There was no significant difference in correlation coefficients between reciprocal values of the serum CyC and creatinine clearance (p=0.2043) as well as reciprocal values of the serum ?2-MG levels and creatinine clearance (p=0.3717) between two examined groups of patients. The studies on renal transplant patients with acute graft rejection or infections are warranted.

scholarly journals Predictors of Postoperative Acute Renal Failure after Noncardiac Surgery in Patients with Previously Normal Renal Function

2007 ◽  
Vol 107 (6) ◽  
pp. 892-902 ◽  
Author(s):  
Sachin Kheterpal ◽  
Kevin K. Tremper ◽  
Michael J. Englesbe ◽  
Michael O’Reilly ◽  
Amy M. Shanks ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Creatinine Clearance ◽  
Normal Renal Function ◽  
Noncardiac Surgery ◽  
Intraoperative Management ◽  
All Cause Mortality ◽  
Calculated Creatinine Clearance ◽  
Preoperative Predictors

Background The authors investigated the incidence and risk factors for postoperative acute renal failure after major noncardiac surgery among patients with previously normal renal function. Methods Adult patients undergoing major noncardiac surgery with a preoperative calculated creatinine clearance of 80 ml/min or greater were included in a prospective, observational study at a single tertiary care university hospital. Patients were followed for the development of acute renal failure (defined as a calculated creatinine clearance of 50 ml/min or less) within the first 7 postoperative days. Patient preoperative characteristics and intraoperative anesthetic management were evaluated for associations with acute renal failure. Thirty-day, 60-day, and 1-yr all-cause mortality was also evaluated. Results A total of 65,043 cases between 2003 and 2006 were reviewed. Of these, 15,102 patients met the inclusion criteria; 121 patients developed acute renal failure (0.8%), and 14 required renal replacement therapy (0.1%). Seven independent preoperative predictors were identified (P &lt; 0.05): age, emergent surgery, liver disease, body mass index, high-risk surgery, peripheral vascular occlusive disease, and chronic obstructive pulmonary disease necessitating chronic bronchodilator therapy. Several intraoperative management variables were independent predictors of acute renal failure: total vasopressor dose administered, use of a vasopressor infusion, and diuretic administration. Acute renal failure was associated with increased 30-day, 60-day, and 1-yr all-cause mortality. Conclusions Several preoperative predictors previously reported to be associated with acute renal failure after cardiac surgery were also found to be associated with acute renal failure after noncardiac surgery. The use of vasopressor and diuretics is also associated with acute renal failure.

scholarly journals Characteristics of neuromuscular block after administration of rocuronium bromide in patients with end-stage renal failure

2011 ◽  
Vol 139 (11-12) ◽  
pp. 765-771
Author(s):  
Nevena Kalezic ◽  
Biljana Krivic ◽  
Vladan Zivaljevic ◽  
Djordje Ugrinovic ◽  
Dijana Jovanovic ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Normal Renal Function ◽  
Neuromuscular Block ◽  
Onset Time ◽  
Cumulative Effect ◽  
Control Group ◽  
Rocuronium Bromide ◽  
Duration Time ◽  
Development Duration

Introduction. Anaesthesia affects kidney function by reducing the renal blood flow and glomerular filtration rate. As chronic renal failure (CRF) significantly influences drug metabolism and elimination, we studied the effects of rocuronium bromide (RB) in patients with CRF. Objective. The aim of the study was to examine whether, when using RB in patients with CFR, there are differences regarding the onset time of neuromuscular block (NMB) development, duration time, speed of recovery and cumulative effects of RB. Methods. Prospective study included 60 patients who underwent urologic surgery procedures. The patients were divided into 3 groups: the first group (G1) - 20 patients with CRF and residual dieresis, the second group (G2) - 20 patients with CRF and without dieresis, and third group (G3) - 20 patients with normal renal function (control group). During surgery RB was administrated for muscle paralysis in all patients. Train-of-four (TOF) Guard acceleromyography was used for NMB monitoring. Results. Onset time in three groups was 132.3 s; 139.5 s and 113.2 s (r<0.01). Duration of intubation dose was the same in G1 and G2 (28.9 minutes), while in the third group it was 27.2 minutes (r>0.05). The number of RB repeated doses was 3-8, 3-7 and 4-8 (r>0.05). The duration time until spontaneous recovery was 31.8, 31.6 and 29.8 minutes (r>0.01). The recovery index was 16.8, 16.7 and 10.6 minutes (r<0.001). The duration time from the last dose of RB to extubation was 74.5, 74.8 and 58.9 minutes (r<0.001). Conclusion. In patients with CRF the cumulative effect of the drug was registered, with a prolonged recovery time from NMB in relation to the patients with normal renal function.

Dosage Regimen Adjustments in Renal Impairment

1973 ◽  
Vol 7 (9) ◽  
pp. 382-387 ◽  
Author(s):  
Donald L. Giusti ◽  
William L. Hayton
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Renal Impairment ◽  
Creatinine Clearance ◽  
Dosage Regimen ◽  
Drug Dosage ◽  
Loading Dose ◽  
Dosage Regimens ◽  
Drug Dosage Regimen ◽  
Pharmacokinetic Approach

A pharmacokinetic approach based on creatinine clearance has been outlined which permits drug dosage regimen adjustments in patients with renal impairment. The parameters needed for calculating a loading dose and a maintenance regimen are the fraction of a dose excreted unchanged in the urine, the creatinine clearance of the patient, and the half-life of the drug in patients with normal renal function. In varying degrees of renal failure, predicted dosage regimens agree closely with dosage regimens predicted by other methods for a number of drugs.

Deterioration of glomerular endothelial surface layer and the alteration in the renal function after a growth promoter boldenone injection in rabbits

2011 ◽  
Vol 31 (5) ◽  
pp. 465-472 ◽  
Author(s):  
A Alm-Eldeen ◽  
E Tousson
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Surface Layer ◽  
Biochemical Analysis ◽  
Control Group ◽  
Growth Promoter ◽  
Mass Reduction ◽  
Endothelial Surface ◽  
G Ratio ◽  
New Zealand Rabbits

Boldenone is an anabolic steroid developed for veterinary use. Recently, it is used by bodybuilders in both off-season and precontest, where it is well known for increasing vascularity while preparing for a bodybuilding contest. However, the side effect of this steroid on the human health is still unclear. Therefore, the present study was designed to investigate the possible effect of the growth promoter, boldenone undecylenate, on the function and structure of the rabbit’s kidneys. A total of 36 adult New Zealand rabbits were divided into 4 groups. Control group includes animals that were injected intramuscularly with olive oil and dissected after 3 weeks. Three experimental groups include animals that receive one, two and three intramuscular injections of 5 mg/kg body weight boldenone, and dissected after 3, 6, and 9 weeks, respectively, and the interval of each dose of boldenone was 3 weeks. The biochemical analysis of the blood serum of treated rabbit showed a significant increase in the total protein, urea and creatinine concentrations, with a significant decrease in albumin/globulin (A/G) ratio. At the same time, a significant glomerulus mass reduction that accompanied with the expression of CD34, a marker for endothelial cells deterioration, was also determined. The incidence of the glomerulosclerosis was significantly increased compared with the control group (0.46 ± 0.05, p < 0.05). The glomerulosclerosis scores were 1.32 ± 0.10, 2.14 ± 0.11 and 3.02 ± 0.09 in groups 2, 3 and 4, respectively. These findings suggest that misuse of the boldenone undecylenate may contribute to the occurrence of a chronic renal injury that may lead to a progressive renal failure.

Increased Fibrinogen Levels and Hemostatic Abnormalities in Patients with Arteriolar Nephrosclerosis: Association with Cardiovascular Events

2000 ◽  
Vol 84 (10) ◽  
pp. 565-570 ◽  
Author(s):  
Laura Zingaro ◽  
Cristiana Catena ◽  
Sergio De Marchi ◽  
Leonardo Sechi
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Creatinine Clearance ◽  
Normal Renal Function ◽  
Cardiovascular Events ◽  
Plasma Fibrinogen ◽  
Atherosclerotic Disease ◽  
Prothrombotic State ◽  
Arteriolar Nephrosclerosis ◽  
D Dimer

SummaryIncreased plasma fibrinogen levels and hemostatic abnormalities suggestive of a prothrombotic state are present in patients with endstage renal failure and could contribute to increased cardiovascular morbidity in these patients. We investigated the relationship between abnormalities of the hemostatic system and the degree of renal failure and whether these abnormalities are associated with increased prevalence of cardiovascular events in patients with arteriolar nephrosclerosis. In 425 patients recruited at a hypertension clinic we assessed the renal function by creatinine clearance, urinary protein excretion, and microalbuminuria, the prevalence of atherosclerotic disease, and measured prothrombin time, activated partial thromboplastin time, fibrinogen, prothrombin fragment 1+2 (F1+2), D-dimer, and antithrombin. Early impairment of renal function (creatinine clearance, 30 to 89 ml/min per 1.73 m2 of body surface area) caused by arteriolar nephrosclerosis was found in 172 patients. Patients with early renal failure were significanly older and had significantly greater values of blood pressure, plasma fibrinogen, F1+2, and D-dimer than patients with normal renal function. Elevated D-dimer and fibrinogen levels were independently associated with the presence of decreased creatinine clearance. Log fibrinogen, log F1+2, and log D-dimer were inversely correlated with creatinine clearance. The prevalence of coronary artery, cerebrovascular, and peripheral vascular disease was significantly greater in patients with mild renal failure than in those with normal renal function. Elevated levels of fibrinogen and D-dimer were associated with the presence of atherosclerotic disease independent of renal function and other risk factors. In conclusion, changes in hemostatic parameters occur early in the course of renal failure in patients with arteriolar nephrosclerosis, suggesting a prothrombotic state that may contribute to the risk for atherosclerotic disease at all levels of renal function.

Use of cystatin C as a marker to detect renal insufficiency in head and neck cancer patients with cisplatin-based chemotherapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17048-e17048
Author(s):  
E. Bölke ◽  
S. Gripp ◽  
C. Matuschek ◽  
D. Hermsen ◽  
M. Peiper ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Head And Neck Cancer ◽  
Kidney Disease ◽  
Creatinine Clearance ◽  
Head And Neck ◽  
Cystatin C ◽  
Neck Cancer ◽  
Plasma Clearance ◽  
Correlation Coefficients ◽  
Plasma Creatinine

e17048 Background: Knowledge of the usefulness of cystatin C measurement in the detection of chronic kidney disease in patients with head and neck cancer (HNC) is scant. The purpose of this study was to evaluate the ability of plasma cystatin C- and creatinine-based methods to predict glomerular filtration rate (GFR) and classify chronic kidney disease in HNC patients before receiving cisplatin based chemotherapy. Methods: The study population consisted of 43 HNC patients aged 39–76 years. Comparisons were made between measured plasma creatinine, cystatin C, creatinine clearance and GFR estimated by the Modification of Diet in Renal Disease (MDRD) formula. The plasma clearance of (51)Cr-EDTA served as a reference method. Results: The Pearson correlation coefficients between plasma clearance of (51)Cr-EDTA and the markers of GFR were calculated. The correlation coefficients were 0.765 for cystatin C, 0.688 for plasma creatinine, 0.585 for GFR values estimated by MDRD and 0.568 for plasma creatinine clearance. Conclusions: We recommend using cystatin C for the estimation of the GFR of HNC patients instead of solely creatinine or creatinine clearance in clinical practice. No significant financial relationships to disclose.

scholarly journals Comparison of Cystatin C and Creatinine as Predictors of Cardiovascular Events in a Community-Based Elderly Population

2010 ◽  
Vol 56 (5) ◽  
pp. 799-804 ◽  
Author(s):  
John Beilby ◽  
Mark L Divitini ◽  
Matthew W Knuiman ◽  
Enrico Rossi ◽  
Joseph Hung
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Renal Function ◽  
Heart Disease ◽  
Creatinine Clearance ◽  
Cystatin C ◽  
Cardiovascular Events ◽  
Community Based ◽  
Hazard Ratios

Abstract Background: Reduced renal function is an established risk factor for cardiovascular events. We compared 3 measures of renal function—serum cystatin C, serum creatinine, and calculated creatinine clearance—as predictors of subsequent cardiovascular events in a community-based population of elderly individuals. Methods: Comprehensive cardiovascular risk factor data were available for 1410 surviving participants of previous Busselton health surveys who were ≥60 years old. Hazard ratios for risk of incident coronary heart disease and cardiovascular disease over 10 years of follow-up were derived for each baseline measure of renal function by use of Cox regression. Results: All measures of renal function were significantly related to risks of morbidity and mortality from coronary heart disease and cardiovascular disease. There were 453 incident cardiovascular disease events; and the age- and sex-adjusted hazard ratios (95% CIs) were 1.34 (1.23–1.46), 1.32 (1.20–1.45), and 1.22 (1.06–1.41) per 1-SD deterioration in cystatin C, creatinine, and creatinine clearance, respectively. All 3 measures gave approximately the same age-adjusted relative risk estimates. After further adjustment for established cardiovascular risk factors, the relative risk estimates were all reduced but remained statistically significant (P &lt; 0.05). Cystatin C was not a significant predictor for cardiovascular disease after adjustment for creatinine clearance. Conclusions: In relation to predicting risk for coronary heart disease or cardiovascular disease over a 10-year follow-up in a community-based population of elderly subjects, there was no evidence that cystatin C was a better risk predictor than creatinine or creatinine clearance.

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