scholarly journals Cystatin C in the early diagnosis of diabetic nephropathy and its correlation with albuminuria

2017 ◽  
Vol 4 (1) ◽  
pp. 56
Author(s):  
Kunal Gupta ◽  
S.B. Nayyar ◽  
Jasmine Sachdeva ◽  
Prateek Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Cystatin C ◽  
Metabolic Disorders ◽  
Multiple Organ ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Organ Systems ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycaemia. The metabolic dysregulations associated with DM causes secondary pathophysiological changes in multiple organ systems which result in various complications, responsible for the morbidity and mortality associated with the disease.Methods: The present study was undertaken in the Department of Medicine in collaboration with the Department of Biochemistry, of SGRDIMSR, Vallah, Sri Amritsar, Punjab, India. The present hospital based study was undertaken with a total number of 100 patients.Results: The mean Cystatin C values in Group A were 1.73 and mean Cystatin C values in group B were 2.07. The results show that the Cystatin C values were raised even in the patients in whom clinical albuminuria had not yet started.Conclusions: serum Cystatin C may be considered as an early marker, than microalbuminuria and serum creatinine, the commonly used marker for nephropathy, for declining renal function, in diabetic subjects. Further studies in larger population are needed to confirm this result.

Factors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin C in patients with rheumatoid arthritis

2020 ◽  
Author(s):  
Mitsuhiro Kawano ◽  
Akikatsu Nakashima ◽  
Shigeto Horita ◽  
Takahiro Matsunaga ◽  
Ryo Inoue ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Diabetes Mellitus ◽  
Renal Function ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Stage 4 ◽  
Group A ◽  
Group B

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.

scholarly journals Factors contributing to discrepant estimated glomerular filtration values measured by creatinine and cystatin C in patients with rheumatoid arthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Akikatsu Nakashima ◽  
Shigeto Horita ◽  
Takahiro Matsunaga ◽  
Ryo Inoue ◽  
Takeshi Zoshima ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Diabetes Mellitus ◽  
Renal Function ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Group A ◽  
Group B

AbstractThis 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. We retrospectively evaluated clinical features, disease activity, Steinbrocker radiological staging, 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) and Group B (eGFR-Cr/eGFR-CysC < 1.2), and searched for factors independently related to Group A. Forty-five patients (18.9%) were assigned to Group A, and 193 (81.1%) to Group B. 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 stage (OR 10.309, 95% CI 2.994–35.714) were identified as independent relevant factors for Group A by a multifactorial analysis. 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.

scholarly journals A Comparative Study of Serum Cystatin C, Serum Electrolytes, Urea and Creatinine in Early Detection of Kidney Injuries in Albino Rats Exposed to Formaldehyde

2021 ◽  
Vol 1 (1) ◽  
pp. 1-4
Author(s):  
Michael Chinedu Olisah ◽  
◽  
Samuel C. Meludu ◽  
Keyword(s):  
Cystatin C ◽  
Low Dose ◽  
Control Group ◽  
Albino Rats ◽  
High Dose ◽  
Serum Cystatin C ◽  
Serum Electrolytes ◽  
Serum Cystatin ◽  
Group A ◽  
Group B

Aim: To ascertain early detection of possible kidney injuries in albino rats exposed to formaldehyde by assessing cystatin C, serum electrolytes, urea and creatinine. Materials/Methods: Thirty healthy adult male albino rats, weighing between 100 to 120 grams were randomly divided into three groups A, B and C. Group A served as control. Group B was exposed to low dose (100ppm of Formaldehyde), 3 hrs per day for four weeks, while group C was exposed to high Dose-200ppm of formaldehyde 3 hrs per day for four weeks. At the end of the exposure period, the rats were sacrificed by decapitation under chloroform anesthesia, and 4 ml of blood samples was collected from each rat into a plain bottle. The whole blood was allowed to clot, retracted and centrifuged at 3000 rpm for 10 minutes and serum separated. The serum was stored at -20˚C until analyses for serum electrolytes, creatinine and cystatin C. Serum electrolytes were determined using Ion selective electrode, urea and creatinine were determined using spectrophotometric methods while cystatin C was analyzed using Eliza. Data obtained was analyzed using SPSS. Results: The concentrations of the serum electrolytes, sodium. Potassium, bicarbonate and chloride were compared across the three group, they were not statistically significant (p>0.05). Urea was significantly higher in group C when compared with low dose B and control group A (P<0.05). Also, when the low dose group B was compared with the high dose group C, it was statistically significant. Creatinine concentrations were significantly higher in group C when compared with the control group A, while group B was not significant when compared with group A. Finally, the cystatin C concentrations were also significant when groups B, C were compared with the control group. Conclusion: Formaldehyde exposures may induce a gradual deterioration of renal functions in chronically exposed albino rats. Serum electrolytes, urea and creatinine may not be sufficient to indicate an early signs of kidney damage. From the study, serum cystatin C may be a better marker of renal impairment in early stages.

scholarly journals Diagnostic Accuracy of Serum Cystatin C for Early Recognition of Nephropathy in Type 2 Diabetes Mellitus

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Suman Sapkota ◽  
Saroj Khatiwada ◽  
Shrijana Shrestha ◽  
Nirmal Baral ◽  
Robin Maskey ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Cystatin C ◽  
Hdl Cholesterol ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
The Mean

Objectives. Diabetic nephropathy is one of the major complications that develop over time in type 2 diabetes mellitus (T2DM). This prospective study was conducted to assess the diagnostic accuracy of serum cystatin C in detecting diabetic nephropathy at earlier stages. Materials and Methods. This study was undertaken on 50 cases of T2DM and 50 healthy subjects as controls. Demographic and anthropometric data and blood and urine samples were collected. The concentration of serum cystatin C (index test) and traditional markers of diabetic nephropathy, serum creatinine, and urinary microalbumin (the reference standard) were estimated. Similarly, blood glucose, glycated haemoglobin (HbA1c), triglycerides, total cholesterol, high-density lipoprotein (HDL) cholesterol, and urinary creatine were measured. Results. The mean ± SD serum cystatin C was significantly higher in T2DM as compared to control (1.07 ± 0.38 and 0.86 ± 0.12 mg/dl, respectively, p < 0.001 ). The mean ± SD bodyweight, BMI, W : H ratio, pulse, SBP, and DBP were 66.4 ± 12.6 kg, 26.2 ± 5.6 kg/m2, 1.03 ± 0.09, 78 ± 7, 125 ± 16 mm of Hg, and 77 ± 9 mm of Hg, respectively, in cases. A significant difference in HDL cholesterol p = 0.018 and serum cystatin C p < 0.001 was observed among different grades of nephropathy. Cystatin C had a significant positive correlation with age (r = 0.323, p = 0.022 ), duration of T2DM (r = 0.326, p = 0.021 ), and UACR (r = 0.528, p < 0.001 ) and a significant negative correlation with eGFR CKD-EPI cystatin C (r = −0.925, p < 0.001 ). The area under ROC curve for serum cystatin C (0.611, 95% CI: 0.450–0.772) was greater than for serum creatinine (0.429, 95% CI: 0.265–0.593) though nonsignificant. Conclusion. Serum cystatin C concentration increases with the progression of nephropathy and duration of diabetes in Nepalese T2DM patients suggesting cystatin C as a potential marker of renal impairment in T2DM patients.

scholarly journals Population Pharmacokinetic Analysis of Vancomycin Using Serum Cystatin C as a Marker of Renal Function

2009 ◽  
Vol 54 (2) ◽  
pp. 778-782 ◽  
Author(s):  
Akihiro Tanaka ◽  
Tetsuya Aiba ◽  
Takashi Otsuka ◽  
Katsuya Suemaru ◽  
Tatsuya Nishimiya ◽  
...  
Keyword(s):  
Renal Function ◽  
Cystatin C ◽  
Predictive Performance ◽  
Pharmacokinetic Analysis ◽  
Pharmacokinetic Parameters ◽  
Population Pharmacokinetic ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
New Model ◽  
The Mean

ABSTRACT We determined the population pharmacokinetics of vancomycin (VAN) using the glomerular filtration rate (GFR) estimated from the serum cystatin C concentration. We examined the predictive performance of the trough serum VAN concentration for determination of the initial dose by using a new model for the analysis of the population pharmacokinetic parameters. Data for 86 patients were used to estimate the values of the population pharmacokinetic parameters. Analysis with a nonlinear mixed-effects modeling program was done by using a one-compartment model. Data for 78 patients were used to evaluate the predictive performance of the new model for the analysis of population pharmacokinetic parameters. The estimated GFR values determined by using Hoek's formula correlated linearly with VAN clearance (VAN clearance [ml/min] = 0.825 × GFR). The mean volume of distribution was 0.864 (liters/kg). The interindividual variability of VAN clearance was 19.8%. The accuracy of the prediction determined by use of the new model was statistically better than that determined by use of the Japanese nomogram-based model because the 95% confidence interval (−3.45 to −1.38) of the difference in each value of the mean absolute error (−2.41) did not include 0. Use of the serum cystatin C concentration as a marker of renal function for prediction of serum VAN concentrations may be useful.

scholarly journals Effect of serum cystatin C in early diabetic nephropathy in type 2 Iraqi diabetic patients

2017 ◽  
Vol 3 (10) ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cystatin C ◽  
Significant Positive Correlation ◽  
Diabetic Patients ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Albumin Excretion

Objective This study aimed to find the effect of serum Cystatin C in early diabetic nephropathy.Method This study was conducted in Al Kindy Teaching Hospital during the period from December, 2015 to June, 2016. The study included 90 subjects (30 males and 30 females) with diabetic type 2 and 30 healthy control. Age is between 30 and 70 years. Patients were with no history of liver disease, thyroid or other endocrine diseases through clinical interviewing. They were divided in to three groups. 30 healthy controls, 30 patients with type 2 diabetes mellitus with no albuminuria (albumin excretion in urine <30 μg/ml ) and 30 patients with type 2 diabetes mellitus with micro albuminuria (albumin excretion in urine >30 μg/ml ).Results There were no significant differences in age, body mass index (BMI) among the studied groups (p > 0.05). Serum Cystatin C levels showed significant difference (p < 0.001) among studied groups, it was significantly higher in micro albuminuria than the other two groups. There was highly significant positive correlation between Cystatin C and serum creatinine (r = 0.697, p < 0.001), and a significant negative correlation between Cystatin C and GFR (r = − 0.455, p = 0.011) and show significant positive correlation between Cystatin C and urine albumin (r = 0.526, p = 0.003 ) in type 2 diabetic patients with micro albuminuria.Conclusion Cystatin C is negatively correlated with the amount of GFR, so that Cystatin C considered reliable and sensitive marker for identifyingchanges in GFR. In type 2 diabetes mellitus with micro albuminuria serum Cystatin C level considered predict marker for renal failure.

scholarly journals Assessment of Cystatin C and Microalbumin as Biomarkers for Nephropathy in Patients with Type 2 Diabetes Mellitus

2021 ◽  
Vol 10 (25) ◽  
pp. 1866-1870
Author(s):  
Bhuneshwar Yadav ◽  
Shashidhar K.N ◽  
Raveesha A ◽  
Muninarayana C.
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Cystatin C ◽  
Elevated Serum ◽  
Diabetic Patients ◽  
Serum Cystatin C ◽  
Serum Cystatin

BACKGROUND Increased levels of urinary biomarkers can be detected in type 2 diabetic patients before the onset of significant albuminuria and may be used as an early marker of renal injury in diabetic nephropathy (DN) which would play a significant role for the effective management and treatment approaches in diabetic care. We wanted to evaluate cystatin C and microalbumin as effective early biomarkers in assessing nephropathy in patients with type 2 diabetes mellitus in this study. METHODS A cross-sectional study was conducted among 180 subjects grouped into healthy controls, clinically proven T2DM without nephropathy and type 2 DM with nephropathy comprising 60 participants in each group. Fasting and postprandial blood samples and urine samples were collected and analysed by standard methods. eGFR was calculated using CKD-EPI 2012 equation. IBM - SPSS version 20 was used for statistical analysis. RESULTS Diabetic nephropathy patients had significantly elevated serum cystatin C and microalbumin (2.43 ± 0.59, 700.5 ± 591.8 mg / L, respectively), compared to T2DM (0.98 ± 0.26, 63.7 ± 102.9 mg / L, respectively), and the control study subjects (0.81 ± 0.16, 11.15 ± 8.9 mg / L, respectively). Serum cystatin C showed AUC of 0.994 (95 % CI, 0.986 - 1.00) whereas microalbumin showed 0.944 (95 % CI, 0.907 - 0.981). Serum cystatin C showed a sensitivity of 96.7 % and a specificity of 91.7 % at a cutoff point of 1.34 mg / L whereas at a cut-off point of 138.5 mg / L for microalbumin, the sensitivity and specificity were 90 % and 83.3 % respectively. CONCLUSIONS Serum cystatin C and microalbumin both could be considered as markers for early detection of nephropathy in T2DM patients. The more prominent rise in serum cystatin C values provide an earlier diagnosis of diabetic nephropathy among T2DM patients. KEY WORDS Biomarker, Type 2 Diabetes Mellitus, Cystatin C, Diabetic Nephropathy, Microalbumin

scholarly journals Dipeptidyl peptidase-4 inhibitor (teneligliptin) significantly reduces liver fat content and delays progression of non-alcoholic steatohepatitis in type 2 diabetes mellitus patients

2021 ◽  
Vol 8 (12) ◽  
pp. 1817
Author(s):  
Vishal Kumar Gupta ◽  
Richa Giri ◽  
Saurabh Agrawal
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Dipeptidyl Peptidase ◽  
Liver Fat ◽  
Liver Fat Content ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Dipeptidyl peptidase (DPP)-4 inhibitors, anti-diabetic agents, are expected to be effective for treatment of non-alcoholic fatty liver disease (NAFLD). Several studies have shown that some DPP-4 inhibitors alleviate hepatic steatosis or steatohepatitis in type 2 diabetic mice or rats. Teneligliptin is DPP4 inhibitor whose efficacy to control blood sugar is well established but its effect on liver is not studied well. In present study we investigated effect of teneligliptin, a DPP-4 inhibitor on patients of type 2 diabetes with non-alcoholic steatohepatitis (NASH). Methods: This was a randomized, double-blind study in which 64 patients between ages of 18 to 80 years were selected for study. Participants were identified as type 2 diabetes with biopsy confirmed NASH. We excluded the patients with glucocorticoid use, hepatitis B or C, and other diseases that might affect liver function. Results: The mean HbA1c change after 48 weeks of therapy in group A was-1.06 % and in group B was-0.77% and this was statistically insignificant (p>0.06). The mean AST change after 48 weeks of therapy in group A was-45.4% and in group B was-33.3% and this was statistically significant (p<0.001). The mean ALT change after 48 weeks of therapy in group A was-41.6% and in group B was-22.7% and this was statistically significant (p<0.001). The change in liver fat content (LFC) after 48 weeks of therapy in group A was-15.4% and group B was-7.14% and this was also statistically significant (p<0.001).Conclusions: Result of our study revealed that teneligliptin significantly reduce serum transaminases in patients of NASH with type 2 DM. Teneligliptin significantly reduce LFC and delay progression of NASH independent of diabetes control in type 2 diabetes mellitus (DM) patients. These data show significant antisteatotic and anti-inflammatory effect of teneligliptin in type 2 diabetes patients.

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